Baatz Holger, Darawsha Raed, Ackermann Hanns, Scharioth Gábor B, de Ortueta Diego, Pavlidis Mitrofanis, Hattenbach Lars O
Recklinghausen Eye Centre, Recklinghausen, Germany.
Invest Ophthalmol Vis Sci. 2008 Mar;49(3):1079-83. doi: 10.1167/iovs.07-0557.
To investigate whether cataract surgery by phacoemulsification induces progression of early age-related macular degeneration (AMD) to neovascular AMD.
Retrospective case-control study. Included were consecutive patients who had undergone phacoemulsification from January 2000 to February 2006 at the Recklinghausen Eye Centre, who had a preexisting diagnosis of early AMD and who were followed up for at least 1 year after surgery (n = 1152 eyes of 696 patients). The control group comprised phakic patients diagnosed with early AMD from January 2000 to February 2006, who did not undergo eye surgery and were followed up for at least 1 year (n = 334 eyes of 202 patients).
At baseline, control eyes had significantly better visual acuity than those of patients who were going to have cataract surgery (0.30/0.35 +/- 0.34 vs. 0.40/0.49 +/- 0.34, respectively; median/mean +/- SD; P < 0.001, Mann-Whitney rank sum test). After 1 year, visual acuity in the control group was worse than in surgical eyes (0.30/0.39 +/- 0.38 vs. 0.20/0.26 +/- 0.30, respectively; median/mean +/- SD; P < 0.001, Mann-Whitney rank sum test). In the cataract surgery group, neovascular AMD developed in 28 (2.43%) of 1152 eyes in the first postoperative year. In the control group, it developed in 6 (1.74%) of 344 eyes within 1 year. There was no significant difference between the groups in the incidence of neovascular AMD (P = 0.57, odds ratio 1.30, 95% CI 0.52-3.24, logistic regression analysis, adjusted for age and baseline visual acuity).
The results indicate that cataract surgery in eyes with early AMD is not a causative factor in neovascular AMD.
研究白内障超声乳化手术是否会促使早期年龄相关性黄斑变性(AMD)进展为新生血管性AMD。
回顾性病例对照研究。纳入2000年1月至2006年2月在雷克林豪森眼科中心接受超声乳化手术、术前已诊断为早期AMD且术后至少随访1年的连续患者(696例患者的1152只眼)。对照组包括2000年1月至2006年2月诊断为早期AMD、未接受眼部手术且至少随访1年的有晶状体眼患者(202例患者的334只眼)。
基线时,对照组眼的视力显著优于即将接受白内障手术患者的眼(分别为0.30/0.35±0.34与0.40/0.49±0.34;中位数/平均值±标准差;P<0.001,曼-惠特尼秩和检验)。1年后,对照组的视力比手术眼差(分别为0.30/0.39±0.38与0.2 /0.26±0.30;中位数/平均值±标准差;P<0.001,曼-惠特尼秩和检验)。在白内障手术组中,1152只眼中有28只(2.43%)在术后第一年发生了新生血管性AMD。在对照组中,344只眼中有6只(1.74%)在1年内发生了新生血管性AMD。两组间新生血管性AMD的发生率无显著差异(P = 0.57,优势比1.30,95%可信区间0.52 - 3.24,逻辑回归分析,校正年龄和基线视力)。
结果表明,早期AMD患者的白内障手术不是新生血管性AMD的致病因素。