Moorfields Eye Hospital, London, United Kingdom.
J Cataract Refract Surg. 2010 Aug;36(8):1311-5. doi: 10.1016/j.jcrs.2010.01.034.
To evaluate differences in visual recovery after phacoemulsification with direct or tilted surgical microscope illumination using a macular photostress test.
Western Eye Hospital, Imperial College Health Care National Health Service Trust, London, United Kingdom.
This randomized double-masked controlled trial enrolled patients presenting to a daycare unit for single-eye cataract surgery. Inclusion criteria were no ocular pathology other than cataract, corneal keratometric astigmatism less than 1.50 diopters, intended target of emmetropia in the operated eye, and cataract grade 1 to 3 (Lens Opacification Classification System II). Exclusion criteria were an abnormal preoperative photostress test. Patients were randomized to have phacoemulsification with the operating microscope angled 15 degrees nasal to the fovea (study group) or with the operating microscope directly overhead around the optic disc region (control group). The same surgeon performed all phacoemulsification procedures using a standardized technique and topical anesthesia. Outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuity 10 minutes and 60 minutes postoperatively.
In the 30 patients evaluated, the mean UDVA 10 minutes postoperatively was 0.40 logMAR +/- 0.26 (SD) in the study group and 0.72 +/- 0.36 logMAR in the control group (P<.01). The mean CDVA was 0.18 +/- 0.26 logMAR and 0.44 +/- 0.30 logMAR, respectively (P = .016). There was no significant between-group difference in acuity at 60 minutes.
Tilting the microscope beam away from the fovea resulted in faster visual recovery and less macular photic stress.
No author has a financial or proprietary interest in any material or method mentioned.
使用黄斑光应激试验评估超声乳化白内障吸除术中直接或倾斜手术显微镜照明对视力恢复的差异。
英国伦敦帝国理工学院国民保健服务信托西部眼科医院。
本随机双盲对照试验纳入了日间手术病房单眼白内障手术的患者。纳入标准为除白内障外无其他眼部疾病，角膜角膜散光小于 1.50 屈光度，预期手术眼为正视，白内障分级 1 至 3 级（晶状体混浊分级系统 II）。排除标准为术前光应激试验异常。患者随机分为手术显微镜向黄斑鼻侧倾斜 15 度（研究组）或直接在视盘区域上方（对照组）进行超声乳化白内障吸除术。同一位外科医生使用标准化技术和局部麻醉进行所有超声乳化白内障吸除术。术后 10 分钟和 60 分钟的主要观察指标为未矫正（UDVA）和矫正（CDVA）远视力。
在 30 例评估患者中，研究组术后 10 分钟 UDVA 平均为 0.40 logMAR +/- 0.26（SD），对照组为 0.72 +/- 0.36 logMAR（P<.01）。平均 CDVA 分别为 0.18 +/- 0.26 logMAR 和 0.44 +/- 0.30 logMAR（P =.016）。两组在 60 分钟时的视力均无显著差异。
将显微镜光束从黄斑处倾斜开可加快视力恢复速度，减少黄斑光应激。
没有作者在任何材料或方法上有财务或所有权利益。
