Objective: To explore the correlation between post-cataract surgery visual improvement and speech recognition in elderly individuals with hearing loss. Methods: It was a prospective cohort study. Patients with cataracts scheduled for bilateral phacoemulsification and intraocular lens implantation at the Department of Ophthalmology, Chinese PLA General Hospital between January and September 2024, who also had hearing loss, were enrolled as the observation group. The control group comprised older adults with hearing loss but without cataracts. Data including age, gender distribution, 5-meter best-corrected visual acuity (logarithm of the minimum angle of resolution, logMAR), mean hearing threshold, and speech recognition rate (SRR) were recorded and compared between the two groups. Statistical analyses were performed using the paired t-test, chi-square test, and multivariate linear regression analysis. Results: The observation group included 22 patients, and the control group comprised 10 patients. A statistically significant difference in age was observed between the observation group [(75.18±6.62) years] and the control group [(60.90±4.65) years] (P<0.05). No statistically significant differences were found in gender distribution (observation group: 14 males, 6 females; control group: 4 males, 6 females) or mean hearing thresholds [observation group: (38.14±9.82) dB; control group: (35.70±4.00) dB] between the two groups (both P>0.05). The differences in best-corrected visual acuity and SRR between the two groups were statistically significant (both P<0.05). Postoperatively, bilateral best-corrected visual acuity in the observation group improved significantly compared to preoperative values (right eye: 0.06±0.11 vs. 0.74±0.55; left eye: 0.05±0.09 vs. 0.59±0.35; both P<0.05). No significant changes in mean binaural hearing thresholds were detected (both P>0.05). However, the postoperative SRR increased significantly to 0.82±0.09 compared to the preoperative value of 0.69±0.13 (P<0.05). There were no statistically significant differences in the postoperative best-corrected visual acuity and SRR between the two groups (both P>0.05). Regression analysis using baseline data, adjusted for gender and mean hearing threshold, revealed a significant inverse association between visual acuity and SRR (β=-0.13, 95%CI:-0.22 to -0.04, P<0.05). Conclusions: Visual acuity is correlated with the speech recognition ability in older adults. Post-cataract surgery visual improvement leads to enhanced speech discrimination performance in elderly individuals with concurrent hearing loss, thereby expanding the therapeutic implications of cataract surgery.
目的： 探讨白内障摘除手术后视力提高与伴有听力损失的白内障老年患者言语识别能力的关联关系。 方法： 前瞻性队列研究。选取2024年1至9月在解放军总医院眼科医学部因白内障拟行双眼超声乳化白内障吸除人工晶状体植入术且伴有听力损失的患者为观察组，无白内障的听力损失老年人为对照组，记录并比较两组的年龄、性别分布、5 m最佳矫正视力（最小分辨角的对数）、平均听阈和言语识别率（SRR）。采用配对t检验、卡方检验以及多因素线性回归分析进行统计学评估。 结果： 观察组患者22例，对照组患者10例。观察组年龄［（75.18±6.62）岁］与对照组［（60.90±4.65）岁］比较，差异有统计学意义（P<0.05）；观察组性别分布（男性14例，女性6例）与对照组（男性4例，女性6例）比较，观察组平均听阈［（38.14±9.82）dB］与对照组［（35.70±4.00）dB］比较，差异均无统计学意义（均P>0.05）；观察组视力和SRR与对照组比较，差异均有统计学意义（均P<0.05）。观察组超声乳化白内障吸除人工晶状体植入术后双眼视力（右眼为0.06±0.11，左眼为0.05±0.09）与术前（右眼为0.74±0.55，左眼为0.59±0.35）比较，差异均有统计学意义（均P<0.05）；手术前后双耳的平均听阈差异均无统计学意义（均P>0.05）；术后SRR（0.82±0.09）高于术前（0.69±0.13），差异有统计学意义（P<0.05）。观察组术后视力和SRR与对照组比较，差异均无统计学意义（均P>0.05）。在调整性别和平均听阈后，视力与SRR之间存在显著关联（β=-0.13，95%置信区间：-0.22~-0.04，P<0.05）。 结论： 白内障摘除手术后视力得到改善，可提高白内障伴有听力损失老年患者的言语识别能力，两者存在关联。.