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黄斑裂孔手术后短期(3 天)面朝下体位对视觉功能和与视觉相关生活质量的影响。

Visual function and vision-related quality of life after macular hole surgery with short-duration, 3-day face-down positioning.

机构信息

Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario.

出版信息

Can J Ophthalmol. 2011 Oct;46(5):399-402. doi: 10.1016/j.jcjo.2011.07.015. Epub 2011 Aug 4.

Abstract

OBJECTIVE

To investigate the relationship of vision-related quality of life (VRQOL) and visual function in patients undergoing macular-hole (MH) repair with and without cataract surgery and short-duration, 3-day prone posturing. Previous communications have assessed VRQOL in European and Japanese populations, but this is the first study to investigate VRQOL after MH surgery in a Canadian population.

DESIGN

Prospective interventional case series.

PARTICIPANTS

We studied 20 consecutive eyes in 19 patients with stage 2 and 3 idiopathic macular holes. Of those, 15 received combined cataract and MH surgery, and 5 received MH repair alone.

METHODS

Patients completed the self-administered National Eye Institute 25-item Visual Function Questionnaire before and after surgery. All patients received full ocular examinations pre- and postsurgery. Along with the questionnaire scores, we examined macular-hole closure rates, complications, postoperative visual acuity, and intraocular pressure.

RESULTS

Macular-hole closure was achieved in 20 of 20 eyes (100%). Mean postoperative logMAR decreased (i.e., improved) by -0.303 (95% CI, -0.501-- -0.105, p = 0.0047). The Visual Function Questionnaire composite score rose from 82.019 ± 12.612 SD to 88.499 ± 7.963 SD (p = 0.012). Subscale scores, including general vision, near activities, mental health, role difficulties, and dependency were all significantly improved (p < 0.05). No complications or intraocular pressure increases were observed.

CONCLUSIONS

Macular-hole surgery followed by short-duration, 3-day face-down positioning significantly improved VRQOL and visual acuity in a group of Canadian patients. The use of VRQOL tools alongside anatomic outcomes provide a more comprehensive overview of patients' experiences and satisfaction after surgical intervention.

摘要

目的

调查行黄斑裂孔(MH)修复术且伴有和不伴有白内障手术及短时间(3 天)俯卧位的患者的视力相关生活质量(VRQOL)与视觉功能的关系。之前的研究评估了欧洲和日本人群的 VRQOL,但这是第一项在加拿大人群中研究 MH 手术后 VRQOL 的研究。

设计

前瞻性干预性病例系列研究。

参与者

我们研究了 19 例 20 只眼的 2 期和 3 期特发性黄斑裂孔患者。其中,15 例患者接受了白内障联合 MH 手术,5 例患者仅接受了 MH 修复术。

方法

患者在手术前后完成了自我管理的国家眼科研究所 25 项视觉功能问卷。所有患者在手术前后均接受了全面的眼部检查。除了问卷评分,我们还检查了 MH 闭合率、并发症、术后视力和眼内压。

结果

20 只眼中有 20 只(100%)实现了 MH 闭合。平均术后 logMAR 降低(即改善)了-0.303(95%置信区间,-0.501-- -0.105,p = 0.0047)。视觉功能问卷综合评分从 82.019 ± 12.612 标准差升至 88.499 ± 7.963 标准差(p = 0.012)。一般视力、近视力活动、心理健康、角色困难和依赖性等子量表评分均显著提高(p < 0.05)。未观察到并发症或眼内压升高。

结论

在一组加拿大患者中,行 MH 手术后进行短时间(3 天)俯卧位治疗可显著提高 VRQOL 和视力。使用 VRQOL 工具与解剖学结果相结合,可以更全面地了解患者在手术干预后的体验和满意度。

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