Zhu Mingming, Huang Jiannan, Zhu Bijun, Sun Qian, Xu Xian, Miao Yuyu, Zou Haidong
Department of Ophthalmology, Shanghai First People's Hospital, Shanghai JiaoTong University, Shanghai, China.
Department of Ophthalmology, Shanghai First People's Hospital, Shanghai JiaoTong University, Shanghai, China; Shanghai Eye Disease Prevention & Treatment Center, Shanghai, China.
PLoS One. 2015 Mar 12;10(3):e0120505. doi: 10.1371/journal.pone.0120505. eCollection 2015.
Rhegmatenous retinal detachment (RRD) is one of the most serious complications after phacoemulsification combined with intraocular lens implantation surgery. It has been reported that vision-related quality of life (VRQoL), as well as visual acuity rapidly decreased when RRD developed. However, little is known of the VRQoL in those RRD patients after anatomical retinal re-attachment, especially whether or not the VRQoL is higher than that before cataract surgery. In this prospective case series study, we use the Chinese-version low vision quality of life questionnaire (CLVQOL) to assess the changes of VRQoL in age-related cataract patients who suffered from RRD after phacoemulsification with intraocular lens (phaco-IOL) implantation. All participants were asked to complete questionnaires in face- to-face interviews one day before and two weeks after cataract surgery, as well as one day before and three months after RRD surgery. A total of 10,127 consecutive age-related cataract patients were followed up to one year after phaco-IOL implantation; among these patients, 17 were diagnosed as RRD. The total CLVQOL scores and subscale scores except "Mobility" decreased significantly when RRD developed. After retinal surgery, only the score of "General vision and lighting" in the CLVQOL questionnaires improved when compared to the scores two weeks after cataract surgery, although the best corrected visual acuity of all patients significantly raised up. However, the mean CLVQOL scores and subscale scores were still considerably higher than the level prior to cataract surgery. Our study suggests that cataract patients at high risk of postoperative RRD should not deny the opportunity to undergo phaco-IOL implantation, even though potential VRQoL impairment induced by RRD exists.
孔源性视网膜脱离(RRD)是白内障超声乳化吸除联合人工晶状体植入术后最严重的并发症之一。据报道,RRD发生时,与视力相关的生活质量(VRQoL)以及视力会迅速下降。然而,对于那些视网膜解剖复位后的RRD患者的VRQoL知之甚少,尤其是其VRQoL是否高于白内障手术前。在这项前瞻性病例系列研究中,我们使用中文版低视力生活质量问卷(CLVQOL)来评估年龄相关性白内障患者在白内障超声乳化吸除联合人工晶状体(phaco-IOL)植入术后发生RRD时VRQoL的变化。所有参与者被要求在白内障手术前一天、术后两周、RRD手术前一天和术后三个月进行面对面访谈时完成问卷。共有10127例连续的年龄相关性白内障患者在phaco-IOL植入术后随访一年;其中17例被诊断为RRD。RRD发生时,CLVQOL总分及除“活动能力”外的各子量表得分均显著下降。视网膜手术后,与白内障手术后两周的得分相比,CLVQOL问卷中仅“总体视力和照明”得分有所改善,尽管所有患者的最佳矫正视力均显著提高。然而,CLVQOL平均得分及各子量表得分仍显著高于白内障手术前的水平。我们的研究表明,即使存在RRD导致的潜在VRQoL损害,术后RRD高危白内障患者也不应放弃接受phaco-IOL植入的机会。