Degenring Robert F, Vey Sonja, Kamppeter Bernd, Budde Wido M, Jonas Jost B, Sauder Gangolf
Department of Ophthalmology Cologne-Merheim, Cologne Hospitals, Cologne, Germany.
Graefes Arch Clin Exp Ophthalmol. 2007 Jan;245(1):18-23. doi: 10.1007/s00417-006-0377-4. Epub 2006 Jul 25.
The purpose of this study was to evaluate the subclinical influence of uncomplicated cataract surgery on foveal thickness and volume in the early postoperative period.
In a prospective study, 108 eyes were assessed by optical coherence tomography preoperatively and 1 day, 1 week and 4 weeks after uncomplicated small incisional phacoemulsification with endocapsular intraocular lens (IOL) implantation under topical anesthesia. The study included 24 eyes of diabetic patients. Eyes with diseases predisposing them for postoperative macular edema, preexisting macular edema, and eyes that developed cystoid macular edema during follow-up were excluded. Main outcome measures were minimal foveal thickness (MFT) and foveal volume. Secondary outcome measure was VA.
Visual acuity (LogMAR) increased significantly (p<0.001) from 0.43+/-0.21 to 0.11+/-0.15 4 weeks after surgery, with a significantly (p=0.001) higher increase in VA for nondiabetic subjects. MFT increased from 183+/-27 mum preoperatively to 191+/-37 mum 4 weeks after surgery (p=0.001), with diabetic patients showing a tendency toward a more pronounced increase in minimal retinal thickness than nondiabetic subjects (p=0.058). One day and 1 week after surgery, MFT measurements were not significantly different from preoperative results. Foveal volume showed a significant increase at 1 week and 4 weeks after surgery (p<0.001), independent of the presence of diabetes (p=0.565). The proportion of patients exhibiting subclinical macular swelling was about 1/5 in the nondiabetic group and 1/3 in the diabetic group. Mean duration of surgery was 11.5+/-6.6 min.
Foveal thickness and foveal volume demonstrate a subclinical increase within 4 weeks after uncomplicated cataract surgery in up to 1/3 of the patients. The amount and frequency of early postoperative subclinical retinal thickening was higher than expected.
本研究的目的是评估单纯性白内障手术在术后早期对黄斑中心凹厚度和体积的亚临床影响。
在一项前瞻性研究中，对108只眼在局部麻醉下进行单纯性小切口超声乳化白内障吸除联合囊内人工晶状体（IOL）植入术前、术后1天、1周和4周时采用光学相干断层扫描进行评估。该研究纳入了24只糖尿病患者的眼睛。排除有术后黄斑水肿易患疾病、术前已存在黄斑水肿以及随访期间发生黄斑囊样水肿的眼睛。主要观察指标为最小黄斑中心凹厚度（MFT）和黄斑中心凹体积。次要观察指标为视力（VA）。
术后4周时，视力（LogMAR）从0.43±0.21显著提高至0.11±0.15（p<0.001），非糖尿病患者的视力提高更为显著（p=0.001）。MFT从术前的183±27μm增加至术后4周的191±37μm（p=0.001），糖尿病患者最小视网膜厚度的增加趋势比非糖尿病患者更为明显（p=0.058）。术后1天和1周时，MFT测量值与术前结果无显著差异。黄斑中心凹体积在术后1周和4周时显著增加（p<0.001），与糖尿病的存在无关（p=0.565）。非糖尿病组出现亚临床黄斑肿胀的患者比例约为1/5，糖尿病组为1/3。平均手术时间为11.5±6.6分钟。
在单纯性白内障手术后4周内，高达1/3的患者黄斑中心凹厚度和黄斑中心凹体积出现亚临床增加。术后早期亚临床视网膜增厚的程度和频率高于预期。
