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特发性眼内黄斑膜与白内障摘除:联合手术与分期手术的比较。

Idiopathic epiretinal macular membrane and cataract extraction: combined versus consecutive surgery.

机构信息

Department of Ophthalmology University Hospital, Rue du Faubourg Raines, Dijon, France.

出版信息

Am J Ophthalmol. 2010 Feb;149(2):302-6. doi: 10.1016/j.ajo.2009.09.011.

Abstract

PURPOSE

To assess the functional and anatomic outcomes of cataract and idiopathic epiretinal macular membrane extraction in combined and consecutive surgeries.

DESIGN

Multicenter, retrospective, comparative case series.

METHODS

One hundred seventy-four patients (174 eyes) with an epiretinal macular membrane (ERM) and cataract were operated on in 1 or 2 sessions in 2 academic centers, Dijon University Hospital and Nancy University Hospital. Combined surgery (n = 109) and consecutive surgery (n = 65) were performed between 2005 and 2006. All patients underwent ERM and internal limiting membrane removal. Cataract extraction was performed with phacoemulsification followed by a posterior chamber intraocular lens implantation. The main outcome measures were near and far visual acuity and central macular thickness evaluated with optical coherence tomography.

RESULTS

After a 12-month follow-up, the postoperative best-corrected visual acuities significantly improved in both the combined and the consecutive surgery groups (near and far vision in both groups, P < .0001). Similarly, the postoperative macular thickness significantly decreased in both groups (P < .0001). We noted no statistical differences between the visual acuity improvement in both groups (near vision, P= .54; far vision, P = .38). However, visual acuity recovery was quicker in the combined surgery group.

CONCLUSIONS

Combined and consecutive surgeries are effective procedures to treat idiopathic ERM. The functional and anatomic results are equivalent in both procedures.

摘要

目的

评估白内障和特发性黄斑视网膜前膜在联合与连续手术中的功能和解剖结果。

设计

多中心、回顾性、对照病例系列研究。

方法

2005 年至 2006 年,在第戎大学医院和南锡大学医院的 2 个学术中心,对 174 例(174 只眼)伴有黄斑视网膜前膜(ERM)和白内障的患者进行了 1 次或 2 次手术。联合手术(n=109)和连续手术(n=65)。所有患者均行 ERM 和内界膜切除术。白内障采用超声乳化吸出术联合后房型人工晶状体植入术治疗。主要观察指标为光学相干断层扫描评估的近视力和远视力以及中心黄斑厚度。

结果

术后 12 个月随访时,联合手术组和连续手术组的最佳矫正视力均显著提高(两组近视力和远视力,P<.0001)。同样,两组的术后黄斑厚度均显著降低(P<.0001)。两组间视力改善无统计学差异(近视力,P=.54;远视力,P=.38)。然而,联合手术组的视力恢复更快。

结论

联合和连续手术是治疗特发性 ERM 的有效方法。两种手术的功能和解剖结果相当。

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