Giocanti-Aurégan A, Tilleul J, Rohart C, Touati-Lefloc'h M, Grenet T, Fajnkuchen F, Chaîne G
Service d'ophtalmologie, hôpital Avicenne, université Paris XIII, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
J Fr Ophtalmol. 2011 Nov;34(9):641-6. doi: 10.1016/j.jfo.2011.02.020. Epub 2011 Sep 1.
Posterior capsular opacification is the commonest complication of cataract surgery. It is treated with Nd:YAG laser capsulotomy. However, after treatment, cases of cystoid macular edema have been reported. The purpose of this study was to measure the foveal thickness change after Nd:YAG capsulotomy using optical coherence tomography (OCT) in order to clarify the physiopathology of this edema.
A prospective, single-center study was conducted on patients who underwent Nd:YAG laser capsulotomy between May 2008 and November 2009. All patients received the same drug protocol after Nd:YAG capsulotomy (acetazolamide, apraclonidine, and rimexolone). Demographic parameters (age, sex, and medical history), clinical features (visual acuity, intraocular pressure) before and after Nd:YAG laser, and laser complications were analyzed. Central foveal thickness was measured by OCT (Stratus OCT 3, Zeiss). Data were collected before Nd:YAG laser capsulotomy and 1 week, 1 month, and 3 months after capsulotomy. The preoperative and postoperative thicknesses were compared. We used a Student t-test for statistical analysis.
Thirty eyes of 26 patients were analyzed. The mean foveal thickness was 209 ± 26 μm before capsulotomy, 213 ± 23 μm, 204 ± 19 μm, 213 ± 23 μm 1 week, 1 month, and 3 months, respectively, after capsulotomy. The foveal thickness did not significantly change during the first 3 months following laser treatment. No complications occurred.
Macular cystoid edema was a classical complication after Nd:YAG capsulotomy. However, there was no significant increase of macular thickness shortly after Nd:YAG capsulotomy in our study.
后囊膜混浊是白内障手术最常见的并发症。通常采用钕:钇铝石榴石激光晶状体囊切开术进行治疗。然而,治疗后有报道出现了黄斑囊样水肿的病例。本研究的目的是使用光学相干断层扫描(OCT)测量钕:钇铝石榴石晶状体囊切开术后黄斑中心凹厚度的变化,以阐明这种水肿的病理生理机制。
对2008年5月至2009年11月期间接受钕:钇铝石榴石激光晶状体囊切开术的患者进行了一项前瞻性单中心研究。所有患者在钕:钇铝石榴石晶状体囊切开术后接受相同的药物治疗方案(乙酰唑胺、阿可乐定和利美索龙)。分析了人口统计学参数(年龄、性别和病史)、钕:钇铝石榴石激光治疗前后的临床特征(视力、眼压)以及激光治疗并发症。通过OCT(蔡司Stratus OCT 3)测量黄斑中心凹厚度。在钕:钇铝石榴石激光晶状体囊切开术前以及术后1周、1个月和3个月收集数据。比较术前和术后的厚度。我们使用Student t检验进行统计分析。
分析了26例患者的30只眼。晶状体囊切开术前黄斑中心凹平均厚度为209±26μm,术后1周、1个月和3个月分别为213±23μm、204±19μm、213±23μm。激光治疗后的前3个月内,黄斑中心凹厚度无明显变化。未发生并发症。
黄斑囊样水肿是钕:钇铝石榴石晶状体囊切开术后的典型并发症。然而,在我们的研究中,钕:钇铝石榴石晶状体囊切开术后不久黄斑厚度并无显著增加。