Cohen Kenneth L, Patel Sheel B, Ray Neepa
Department of Ophthalmology, University of North Carolina at Chapel Hill, School of Medicine, 5110 Bioinformatics Building, 130 Mason Farm Road, Chapel Hill, NC 27599-7040, USA.
J Cataract Refract Surg. 2004 Jul;30(7):1501-6. doi: 10.1016/j.jcrs.2003.12.025.
To measure macular thickness using the Retinal Thickness Analyzer (RTA) (Talia Technologies, Ltd.) before and after routine phacoemulsification.
Ophthalmology Clinic, Ambulatory Care Center, University of North Carolina at Chapel Hill, School of Medicine, and the University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
Thirty-five nonconsecutive patients scheduled for phacoemulsification and posterior chamber intraocular lens implantation were recruited. The best corrected visual acuity (BCVA) and macular thickness in the surgical and nonsurgical eyes were measured with the RTA prior to surgery and 1 and 6 weeks after surgery. Wilcoxon signed rank tests were used to evaluate each index of macular thickness--the mean posterior pole, perifoveal, and foveal thicknesses--over the 3 time periods and to compare the indices before surgery in surgical and nonsurgical eyes. Spearman correlations were computed for each index and the BCVA. Significance was assessed at the 5% level.
Preoperatively, all indices were higher in surgical [corrected] eyes than in nonsurgical [corrected] eyes. In surgical eyes, all indices decreased from preoperatively to 6 weeks after surgery. In nonsurgical eyes, there was no change. The BCVA in surgical eyes improved from before surgery to 1 week and 6 weeks after surgery. In surgical eyes, there were nonsignificant negative correlations between each index and the BCVA before surgery and 1 and 6 weeks after surgery. In nonsurgical eyes, there were nonsignificant negative correlations between each index and the BCVA preoperatively and 6 weeks after surgery, except for a significant negative correlation for the foveal index at 6 weeks.
Measurements by the RTA indicate that the decrease in macular thickness indices in surgical eyes from before surgery to 6 weeks after routine phacoemulsification is an artifact of imaging the retina through hazy media. Therefore, the results must be interpreted in the context of the clinical situation.
使用视网膜厚度分析仪（RTA）（Talia Technologies有限公司）测量常规超声乳化手术前后的黄斑厚度。
美国北卡罗来纳州教堂山北卡罗来纳大学医学院眼科诊所、门诊护理中心以及北卡罗来纳大学医院。
招募35例计划行超声乳化白内障吸除联合后房型人工晶状体植入术的非连续患者。术前、术后1周和6周，使用RTA测量手术眼和非手术眼的最佳矫正视力（BCVA）及黄斑厚度。采用Wilcoxon符号秩检验评估3个时间段内黄斑厚度的各项指标——后极部平均厚度、中心凹周围厚度和中心凹厚度，并比较手术眼和非手术眼术前的指标。计算各指标与BCVA之间的Spearman相关性。显著性检验水准设定为5%。
术前，手术眼的所有指标均高于非手术眼。手术眼中，所有指标从术前至术后6周均下降。非手术眼中，无变化。手术眼的BCVA从术前至术后1周和6周有所改善。手术眼中，术前、术后1周和6周各指标与BCVA之间均存在无统计学意义的负相关。非手术眼中，术前和术后6周各指标与BCVA之间存在无统计学意义的负相关，但术后6周中心凹指标存在显著负相关。
RTA测量结果表明，常规超声乳化手术前后手术眼黄斑厚度指标的下降是通过模糊介质对视网膜成像的假象。因此，必须结合临床情况对结果进行解读。
