Wilmer Eye Institute and Department of Ophthalmology, Baltimore, MD 21236, USA.
Can J Ophthalmol. 2011 Oct;46(5):391-8.e1. doi: 10.1016/j.jcjo.2011.07.008. Epub 2011 Aug 4.
To evaluate the effects of cataract extraction with intraocular lens implantation (CE-IOL) in low-vision patients.
Prospective, interventional case series.
Twenty low-vision patients (30 eyes) underwent CE-IOL by 1 surgeon at an academic institution.
Pre- and post-CE-IOL visual acuities and responses to a 23-page survey (self-reported functioning in general vision, mobility, illumination, and ability to see faces) were compared.
Sixteen patients had age-related macular degeneration (AMD); 1 patient each had rod-cone dystrophy, oculocutaneous albinism, retinitis pigmentosa, or cerebrovascular accident. The average age was 78 years (range: 53-96 years). Preoperative best-corrected visual acuity (BCVA) ranged from 20/70 to count fingers; postoperative BCVA at 8 weeks was 20/40 to 20/400, with improvement in 25 (83%) eyes of 15 patients, and no change in the rest. The average change in logMAR of BCVA in the 1 eye or in the eye with better preoperative vision in bilateral surgery was an improvement of 0.6 logMAR units (p = 0.0001). Seventeen (85%) patients noted an improvement in visual function and would consent to CE-IOL again. Twelve patients completed the survey pre- and post-CE-IOL at 3 months. More patients could read with a magnifier after surgery. On average, self-reported functioning was improved.
In this small study, CE-IOL offered subjective and objective benefits to patients from a low vision clinic, many of whom may have been dissuaded from CE-IOL. Most patients had moderately dense cataracts and moderate to advanced AMD, and these features may help form clinical recommendations. Expectations are important to elicit preoperatively. Postoperatively, patients may be more receptive to low-vision services and devices when the prognosis for visual rehabilitation is better.
评估白内障超声乳化吸除联合人工晶状体植入术（CE-IOL）治疗低视力患者的效果。
前瞻性、干预性病例系列研究。
1 位外科医生在学术机构对 20 名低视力患者（30 只眼）进行了 CE-IOL。
比较术前和术后的视力以及对 23 页调查问卷（自我报告的一般视力、移动性、照明和识别人脸的能力）的反应。
16 名患者患有年龄相关性黄斑变性（AMD）；1 名患者分别患有杆状细胞营养不良、眼皮肤白化病、色素性视网膜炎或脑血管意外。平均年龄为 78 岁（范围：53-96 岁）。术前最佳矫正视力（BCVA）从 20/70 到指数；术后 8 周 BCVA 为 20/40 至 20/400，15 名患者中有 25 只眼（83%）改善，其余未改变。1 只眼或双侧手术中术前视力较好的那只眼的 BCVA 对数平均变化为 0.6 logMAR 单位（p=0.0001），改善。17 名（85%）患者表示视觉功能有所改善，并会再次同意接受 CE-IOL。12 名患者在术后 3 个月完成了术前和术后的调查。手术后，更多的患者可以使用放大镜阅读。平均而言，自我报告的功能得到了改善。
在这项小型研究中，CE-IOL 为低视力诊所的患者提供了主观和客观的益处，其中许多患者可能因 CE-IOL 而犹豫不决。大多数患者患有中度密度白内障和中度至晚期 AMD，这些特征可能有助于制定临床建议。术前应了解患者的预期。术后，当视觉康复的预后更好时，患者可能更愿意接受低视力服务和设备。
