Edwards T L, Groppe M, MacLaren R E
Oxford Eye Hospital and Nuffield Laboratory of Ophthalmology, John Radcliffe Hospital, Oxford, UK.
1] Oxford Eye Hospital and Nuffield Laboratory of Ophthalmology, John Radcliffe Hospital, Oxford, UK [2] Moorfields Eye Hospital Foundation Trust, NIHR Ophthalmology Biomedical Research Centre, London, UK.
Eye (Lond). 2015 Apr;29(4):460-4. doi: 10.1038/eye.2014.326. Epub 2015 Jan 16.
PurposeTo present a case series of cataract surgery outcomes in choroideremia eyes with an emphasis on the safety of this common operation in advanced stages of the disease.MethodsA single centre retrospective interventional case series comprising six patients with varying degrees of visual loss secondary to choroideremia underwent cataract surgery at a single tertiary eye hospital. Pre- and post-operative best-corrected Snellen visual acuity, spectral domain optical coherence tomography (SD-OCT), and slit lamp examination were performed together with fundus autofluorescence (FAF) and colour fundus photographs.The prevalence of intra- or post-operative complications, post-operative visual outcome, and change in central macular thickness were recorded.ResultsThe pre-operative best-corrected Snellen visual acuity in the operated eyes ranged from 6/12 (20/40) to PL. All but one patient had either an objective or a subjective improvement in visual acuity. There was no evidence of retinal phototoxicity or post-operative cystoid macular oedema (CMO). Three patients developed early capsular fibrosis.ConclusionsAlthough the residual functioning retina in choroideremia patients may be potentially vulnerable, this report finds no evidence of iatrogenic vision loss after uncomplicated cataract surgery. This suggests that cataract surgery may be performed safely in choroideremia patients, although a guarded prognosis for visual improvement should be emphasized in the informed consent.
目的
呈现脉络膜视网膜炎患者白内障手术结果的病例系列,重点关注该常见手术在疾病晚期阶段的安全性。
方法
一个单中心回顾性干预病例系列,包括六名因脉络膜视网膜炎继发不同程度视力丧失的患者,在一家三级眼科医院接受了白内障手术。术前和术后进行了最佳矫正视力、频域光学相干断层扫描(SD - OCT)、裂隙灯检查,同时进行了眼底自发荧光(FAF)和彩色眼底照相。记录了术中或术后并发症的发生率、术后视力结果以及中心黄斑厚度的变化。
结果
手术眼术前最佳矫正视力范围为6/12(20/40)至光感。除一名患者外,所有患者视力均有客观或主观改善。没有视网膜光毒性或术后黄斑囊样水肿(CMO)的证据。三名患者出现早期囊膜纤维化。
结论
尽管脉络膜视网膜炎患者残留的功能视网膜可能存在潜在脆弱性,但本报告未发现无并发症白内障手术后医源性视力丧失的证据。这表明脉络膜视网膜炎患者可安全地进行白内障手术,不过在知情同意过程中应强调视力改善预后的不确定性。