摘要
目的探讨白内障超声乳化吸除联合人工晶体植入术患者合并年龄相关性黄斑变性(AMD)的比率,分析术后影响视力恢复的因素及手术对AMD的影响。方法回顾性分析白内障超声乳化吸除人工晶体植入术300眼并检查裸眼视力、眼前节及眼底,必要时检查最佳矫正视力(BCVA)。采用SPSS 13.0软件进行统计学分析,P<0.05为差异有统计学意义。结果①术后第1天,BCVA<0.3者45眼(15.00%),≥0.3者255眼(85.00%);术后3个月,BCVA<0.3者18眼(6.00%),≥0.3者282眼(94.00%);②术后眼底正常者215眼,AMD 56眼、糖尿病性视网膜病变13眼、高度近视性视网膜病变7眼、视网膜静脉阻塞3眼、视网膜色素变性和视神经萎缩各2眼、黄斑裂孔和黄斑前膜各1眼;③白内障术后AMD以早中期患者多见,晚期较少,较术前视力均有提高;④白内障术前确诊合并AMD者11眼,术后3个月复查有1眼从早期发展至中期,余未见明显变化,差异无统计学意义(χ2=0.234,P=0.890)。结论 AMD是白内障超声乳化联合人工晶体植入术后影响视力恢复的主要眼底疾病,其次为DR和高度近视性视网膜病变。白内障手术患者合并AMD的比率为18.67%,其中以早中期最为常见。白内障超声乳化联合人工晶体植入术对AMD的发生发展没有明显影响,且能提高术后视力。
Objective To explore the ratio of age-related macular degeneration （AMD） after cataract phacoemulsifica- tion with intraocular lens （IOL） implantation, and analyze the influencial factors of postoperative visual acuity and opera- tional effects on AMD. Methods 300 eyes of cataract phacoemulsification combined with IOL implantation from Janu- ary 2009 to February 2012 in our hospital were retrospectively analyzed. The uncorrected visual acuity, anterior and posterior segment were checked on 1 day, 1 week, 1 month and 3 months postoperatively and the best corrected visual acuity （BCVA） was examined when necessary. BCVA of all patients were examined 3 months after the operation. The visual acuity, complications and fundus check were recorded. Fundus fluorescein angiography （FFA） was performed when patients were diagnosed or suspected as AMD. Indocyanine green angiography （ICGA） and/or optical coherence tomography （OCT） should be examined if needed. The association studies were performed with SPSS 13.0. Results 1. On day 1 postoperative, there were 45 eyes （15.00%） with BCVA 〈 0.3 and 255 eyes （85.00%） with BCVA ≥ 0.3. 3 months operative, there were 18 eyes （6.00%） with BCVA 〈 0.3 and 282 eyes （94.00%） with BCVA ≥ 0.3. 2. After the operation, there were 215 eyes with normal fundus, 56 eyes with AMD, 13 eyes with diabetic retinopathy, 7 eyes with high myopia retinopathy; 3 eyes with retinal vein occlusion; 2 eyes with retinal pigment degeneration, 2 eyes with optic atrophy, 1 eye with macular hole and 1 eye with epiretinal membrane of macular. 3. After cataract surgery, AMD was common in early and intermediate stage but rarely in advanced stage. However, the postoperative visual acuity was better than the preoperative. 4. Before cataract surgery, there were 11 eyes which were diagnosed with cataract and AMD. Except 1 eye developed from early AMD to intermediate stage, the rest did not change obviously after the operation. The difference was not significant （χ2 = 0. 234, P = 0. 890）. Conclusion AMD is the main fundusdisease which affects later vision restoration after cataract phacoemulsification and IOL implantation, followed by DR and high myopia retinopathy. The ratio of AMD is 18.67%, which can be commonly noted in early and intermediate stage after cataract surgery. Cataract operation shows no significant effect on the development of AMD but improves the visual acuity.
出处
《山东大学耳鼻喉眼学报》
CAS
2013年第5期77-83,90,共8页
Journal of Otolaryngology and Ophthalmology of Shandong University
关键词
年龄相关性黄斑变性
白内障
超声乳化
最佳矫正视力
Age-related macular degeneration
Cataract
Phacoemulsification
Best corrected visual acuity
