摘要
目的探讨手持式视网膜视力计和光学相干断层成像技术(OCT)对白内障合并黄斑前膜患者的术后视力预测的意义和临床应用价值。方法回顾分析2019年1月~2020年4月在我院因老年性白内障进行“超声乳化白内障摘除联合人工晶状体植入术”的患者。根据术前检查结果,发现白内障患者的眼底合并有特发性黄斑前膜,以LOCSⅡ晶体混浊分类标准,选取晶体混浊分级为C2N2P1的患者,共45例52眼。并以黄斑中心凹厚度作为分组依据,将患者分为3组:在OCT检查下黄斑中心凹厚度<300μm为A组(9眼),300~400μm为B组(25眼),>400μm为C组(18眼)。比较3组患者术前最佳矫正视力、术前视网膜视力、术后第1天最佳矫正视力、术后3月的最佳矫正视力。分析术前视网膜视力与术后3月最佳矫正视力的一致性。结果3组患者术后1 d、术后3月最佳矫正视力与术前比较差异均有统计学意义(P<0.05)。3组大部分患者术后最佳矫正视力恢复到0.3~0.5。黄斑中心凹厚度<400μm的患者,白内障术后视力≥0.3有31例(91.18%)。黄斑中心凹厚度>400μm,白内障术后视力≥0.3只有14例(77.78%)。术前视网膜视力和术后3月最佳矫正视力之间有正相关关系(r=0.830,P<0.05)。结论合并特发性黄斑前膜的白内障患者,超声乳化白内障摘除联合人工晶状体植入术可以提高患者的术后视力。手持式视网膜视力计能准确评估C2N2P1分级白内障患者术后的视力。黄斑前膜引起黄斑中心凹厚度>400μm的患者,单纯行超声乳化白内障摘除联合人工晶状体植入术,术后视力恢复不理想。
Objective To investigate the value of hand-held retinal optometer and optical coherence tomography(OCT)in predicting postoperative visual acuity in patients with age-related cataract and idiopathic macular epiretinal membrane.Methods We retrospectively analyzed the data of patients undergoing phacoemulsification combined with intraocular lens implantation for age-related cataract in our hospital from January,2019 to April,2020.Preoperative examination detected idiopathic macular epiretinal membrane in 45 of the patients(52 eyes)with lens opacity grade C2N2P1 according to LOCSⅡlens opacity classification criteria.Based on the thickness of the macular fovea,the eyes were divided into group A(9 eyes)with macular thickness<300μm by OCT examination,group B(25 eyes)with macular thickness of 300 to 400μm,and group C(18 eyes)with macular thickness>400μm.The best corrected visual acuity and retinal visual acuity before operation and the best corrected visual acuity on the first day and at 3 months after the surgery were compared among the 3 groups.The consistency between the preoperative retinal vision and the best corrected vision at 3 months after the surgery was analyzed.Results The best corrected visual acuity at one day and 3 months after the surgery differed significantly from that before the surgery in all the 3 groups(P<0.05).The best corrected visual acuity recovered to 0.3-0.5 in most of the patients in the 3 groups.Thirty-one(91.18%)of the patients with a macular thickness less than 400μm had a visual acuity≥0.3 after cataract surgery,as compared with only 14 patients(77.78%)among those with a macular thickness>400μm.There was a positive linear correlation between preoperative retinal visual acuity and best corrected visual acuity at 3 months after the surgery(r=0.830,P<0.05).Conclusion For patients with cataract and idiopathic macular epiretinal membrane,phacoemulsification combined with intraocular lens implantation can improve postoperative vision.Hand-held retinal optometer can accurately assess postoperative vision in patients with stage C2N2P1 cataract.Patients with a macular thickness>400μm caused by idiopathic macular epiretinal membrane are likely to have poor postoperative visual outcomes.
作者
李红阳
黎燕英
薛丽萍
邹红蕾
梁仁隆
杨兵花
吴艺
LI Hongyang;LI Yanying;XUE Liping;ZOU Honglei;LIANG Renlong;YANG Binghua;WU Yi(Department of Ophthalmology,Guangdong Second Provincial People's Hospital,Guangzhou 510310,China)
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2021年第1期123-127,共5页
Journal of Southern Medical University
