Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, Sydney, Australia.
Br J Ophthalmol. 2011 Dec;95(12):1652-5. doi: 10.1136/bjo.2010.197517. Epub 2011 Apr 11.
To assess whether improved visual acuity (VA) is sustained 2 years after the cataract surgery.
The Cataract Surgery and Age-Related Macular Degeneration (CSAMD) study followed 1936 patients aged ≥ 65 years undergoing phacoemulsification cataract surgery at Westmead Hospital (Sydney, Australia) between 2004 and 2007. Presenting and pinhole VA were assessed and retinal photography was performed annually. VA improvement or reduction was defined if VA differed by ≥ 2 lines between 1 and 24 months.
VA data were available for 1809 patients at 1 month and 1294 at both postoperative visits (71.5% of 1809). At the 2-year visit, 930 patients (71.9%) maintained the same pinhole VA levels that they had at 1 month postoperatively, 199 (15.4%) had an improvement and 165 (12.7%) a reduction in pinhole VA. After adjusting for age and gender, pre-existing macular conditions (early AMD, macular hole or previous laser treatment) were associated with pinhole VA reduction (p=0.02). At the 24-month visit, 58.1% of those with presenting VA improvement wore distance spectacles.
One in eight cataract surgical patients lost at least two lines in pinhole VA over the 2-year postoperative period. Regular eye examinations of patients after cataract surgery may help to maximise the surgical benefits over the long term.
评估白内障手术后 2 年是否能保持视力(VA)的提高。
白内障手术与年龄相关性黄斑变性(CSAMD)研究纳入了 1936 名年龄≥65 岁的患者,这些患者于 2004 年至 2007 年期间在西悉尼医院(澳大利亚悉尼)接受了超声乳化白内障手术。研究评估了术前和小孔视力,并每年进行视网膜摄影。如果在 1 至 24 个月之间 VA 差异≥2 行,则定义为 VA 改善或下降。
1 个月时,1809 名患者中有 VA 数据,1294 名患者在两次术后访视时均有 VA 数据(占 1809 名患者的 71.5%)。在 2 年访视时,930 名患者(71.9%)保持了与术后 1 个月相同的小孔视力水平,199 名患者(15.4%)小孔视力提高,165 名患者(12.7%)小孔视力下降。在调整年龄和性别后,预先存在的黄斑病变(早期 AMD、黄斑裂孔或先前的激光治疗)与小孔视力下降相关(p=0.02)。在 24 个月的访视时,58.1%的视力提高患者佩戴远距眼镜。
每 8 名接受白内障手术的患者中就有 1 人在术后 2 年内至少损失 2 行小孔视力。白内障手术后定期对患者进行眼部检查可能有助于长期实现手术效益最大化。