通过光学相干断层扫描评估单纯白内障超声乳化术后黄斑变化
Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography.
作者信息
Perente Irfan, Utine Canan A, Ozturker Can, Cakir Mehmet, Kaya Vedat, Eren Hakan, Kapran Ziya, Yilmaz Omer F
机构信息
Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
出版信息
Curr Eye Res. 2007 Mar;32(3):241-7. doi: 10.1080/02713680601160610.
PURPOSE
To evaluate the effect of uncomplicated phacoemulsification surgery on macula by optical coherence tomography (OCT).
METHODS
A total of 110 eyes of 102 patients who underwent uncomplicated phacoemulsification and foldable intraocular lens implantation at Beyoglu Eye Research and Training Hospital between February and March 2005 and who were without any systemic disease, fundus or other ocular pathology were included. Postoperatively, topical prednisolone acetate (6 x 1) and ofloxacine (5 x 1) was started, and by decreasing the dosage progressively, treatment was continued for 6 weeks. Full ophthalmologic and OCT examinations were done preoperatively and at the postoperative 1st day, 1st week, 1st, 3rd, and 6th months. Mean retinal thicknesses, volumetric analyses at central fovea, superior, inferior, temporal, and nasal macular quadrants, and thinnest foveal retinal thicknesses were recorded. Preoperative and postoperative measurements were analyzed statistically by using ANOVA test, paired samples t-test with Bonferroni correction, and Pearson's correlation test.
RESULTS
The mean central foveal retinal thickness was preoperatively 202.4 +/- 25.9 micro m, postoperatively 200.4 +/- 26.1 micro m at 1st day (p = 0.29), 208.4 +/- 27.6 micro m at 1st week (p = 0.29), 226.2 +/- 54.9 micro m at 1st month, 215.2 +/- 24.0 micro m at 3rd month, 213.5 +/- 29.4 micro m at 6th month (p < 0.001). Perifoveal macular thicknesses at superior, inferior, temporal, and nasal quadrants were 264.9 +/- 28.8 micro m, 266.1 +/- 29.5 micro m, 255.0 +/- 31.3 micro m, 260.3 +/- 34.0 micro m, respectively, preoperatively; 287.9 +/- 28.4 micro m, 288.0 +/- 26.3 micro m, 286.8 +/- 33.1 micro m, 272.0 +/- 32.4 micro m, respectively, at postoperative 1st month (p < 0.001). The change in mean central foveal thickness, foveal thinnest retinal thickness, mean perifoveal retinal thickness and volumetric analyses was insignificant at postoperative 1st day (p > 0.05), and significant at 1st week, 1st, 3rd, and 6th months (p < 0.05 for all measurements).
CONCLUSIONS
Statistically significant increase in macular thickness was detected at postoperative early periods, after the 1st week after uncomplicated cataract operation. The increase in macular thickness starts from parafoveal regions. Longer follow-up of patients is required for the macular consequences, and different treatment protocols should be studied in a randomized controlled fashion.
目的
通过光学相干断层扫描(OCT)评估单纯性白内障超声乳化手术对黄斑的影响。
方法
纳入2005年2月至3月在贝伊奥卢眼科研究与培训医院接受单纯性白内障超声乳化及可折叠人工晶状体植入术、无任何全身性疾病、眼底或其他眼部病变的102例患者的110只眼。术后开始局部使用醋酸泼尼松龙(6×1)和氧氟沙星(5×1),并逐渐减少剂量,持续治疗6周。术前及术后第1天、第1周、第1、3和6个月进行全面的眼科和OCT检查。记录平均视网膜厚度、中央凹、黄斑上、下、颞侧和鼻侧象限的容积分析以及最薄的中央凹视网膜厚度。术前和术后测量结果采用方差分析、经Bonferroni校正的配对样本t检验和Pearson相关检验进行统计学分析。
结果
术前平均中央凹视网膜厚度为202.4±25.9μm,术后第1天为200.4±26.1μm(p = 0.29),第1周为208.4±27.6μm(p = 0.29),第1个月为226.2±54.9μm,第3个月为215.2±24.0μm,第6个月为213.5±29.4μm(p < 0.001)。黄斑上、下、颞侧和鼻侧象限的黄斑旁厚度术前分别为264.9±28.8μm、266.1±29.5μm、255.0±31.3μm、260.3±34.0μm;术后第1个月分别为287.9±28.4μm、288.0±26.3μm、286.8±33.1μm、272.0±32.4μm(p < 0.001)。术后第1天平均中央凹厚度、中央凹最薄视网膜厚度、平均黄斑旁视网膜厚度和容积分析的变化无统计学意义(p > 0.05),而在第1周、第1、3和6个月有统计学意义(所有测量p < 0.05)。
结论
在单纯性白内障手术后第1周后的早期,黄斑厚度有统计学意义的增加。黄斑厚度的增加始于黄斑旁区域。对于黄斑的影响需要对患者进行更长时间的随访,并且应以随机对照的方式研究不同的治疗方案。