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抗血管内皮生长因子治疗时代与年龄相关性黄斑变性相关的白内障手术后的结果。

Outcomes of cataract surgery in patients with neovascular age-related macular degeneration in the era of anti-vascular endothelial growth factor therapy.

机构信息

Retina Vitreous Associates Medical Group, Beverly Hills, California 90211, USA.

出版信息

J Cataract Refract Surg. 2012 Apr;38(4):677-82. doi: 10.1016/j.jcrs.2011.10.036. Epub 2012 Jan 27.

DOI:10.1016/j.jcrs.2011.10.036
PMID:22284725
Abstract

PURPOSE

To evaluate the visual outcomes, choroidal neovascular complex status, and adverse events in patients with visually significant cataract and neovascular age-related macular degeneration (AMD) who had cataract surgery.

SETTING

Private practices, Beverly Hills, California, and New London, Connecticut, USA.

DESIGN

Case series.

METHODS

Data were abstracted from the medical records of patients with neovascular AMD treated by anti-vascular endothelial growth factor (anti-VEGF) therapy who had cataract surgery. The main outcome measures were Snellen corrected distance visual acuity (CDVA), perioperative adverse events, and status of the choroidal neovascular complex.

RESULTS

The study enrolled 30 eyes of 28 patients. The CDVA was 20/40 or better in 10% of eyes preoperatively and 40% postoperatively; 20/50 to 20/100 in 53% and 33%, respectively; and 20/200 or worse in 37% and 27%, respectively. The change in CDVA from preoperatively to postoperatively was statistically significant, with a mean change of 0.22 logMAR ± 0.27 (SD) at 2 months (P<.0001), 0.22 ± 0.36 logMAR at 6 months (P=.001), and 0.17 ± 0.54 logMAR at the last follow-up (P=.01). Patients received a mean of 0.32 injections per month postoperatively compared with 0.49 injections per month preoperatively. Perioperative macular adverse events did not occur in any eye.

CONCLUSIONS

With regular evaluations and appropriate treatment with anti-VEGF agents, cataract surgery did not appear to be associated with an increased incidence of perioperative complications or macular adverse events.

摘要

目的

评估伴有明显白内障和新生血管性年龄相关性黄斑变性(AMD)的患者接受白内障手术后的视力结果、脉络膜新生血管复合状态和不良事件。

设置

美国加利福尼亚州贝弗利山和康涅狄格州新伦敦的私人诊所。

设计

病例系列。

方法

从接受抗血管内皮生长因子(抗-VEGF)治疗的新生血管 AMD 患者的病历中提取数据,这些患者接受了白内障手术。主要观察指标是 Snellen 矫正远视力(CDVA)、围手术期不良事件和脉络膜新生血管复合状态。

结果

该研究纳入了 28 例患者的 30 只眼。术前 CDVA 为 20/40 或更好的占 10%,术后为 40%;20/50 至 20/100 的分别为 53%和 33%;20/200 或更差的分别为 37%和 27%。从术前到术后 CDVA 的变化具有统计学意义,术后 2 个月平均变化 0.22 对数最小分辨角对数视力(logMAR)±0.27(SD)(P<.0001),术后 6 个月为 0.22±0.36 logMAR(P=.001),末次随访时为 0.17±0.54 logMAR(P=.01)。术后患者每月平均接受 0.32 次注射,而术前每月平均接受 0.49 次注射。没有任何一只眼发生围手术期黄斑不良事件。

结论

定期评估和适当使用抗-VEGF 药物治疗,白内障手术似乎不会增加围手术期并发症或黄斑不良事件的发生率。

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