Mönestam Eva
From the Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden.
J Cataract Refract Surg. 2016 Jan;42(1):19-26. doi: 10.1016/j.jcrs.2015.07.040.
To describe the change over a 15-year period in corrected distance visual acuity (CDVA), subjective visual function, and neodymium:YAG (Nd:YAG) frequency after cataract surgery.
Eye Clinic, Norrlands University Hospital, Umeå, Sweden.
Prospective longitudinal population-based cohort study.
Patients who had cataract surgery during a 1-year period, 15 years previously (1997 to 1998), were included. All patients answered the same Visual Function-14 (VF-14) questionnaire preoperatively, 4 months postoperatively, and 5, 10, and 15 years after surgery. Most patients (88%; 168/190; 74% of survivors) also had an ocular examination. The CDVA was measured with logMAR charts.
The study included 190 patients (83% of survivors). Fifteen years after surgery, the median CDVA in the operated eye had deteriorated from 20/20 postoperatively to 20/25 (P = .0001). Sixty percent of the patients had worsening of CDVA of less than 0.1 logMAR units compared with postoperatively. Fifty-four percent (103/190) had no deterioration in subjective visual function (VF-14), and 79% (150/190) had 10 points of decline or less. Previous Nd:YAG laser capsulotomy was more common in those younger than 65 years at surgery (49% versus 25%) (P = .002).
The study confirms the effectiveness of cataract extraction, offering good long-term visual rehabilitation for the majority of the patients. The most common comorbidity causing large functional loss 15 years after surgery was age-related macular degeneration. Fifteen years after surgery, one half of the patients younger than 65 years at surgery had not required a posterior Nd:YAG laser capsulotomy.
The author has no financial or proprietary interest in any method or material mentioned.
描述白内障手术后15年间矫正远视力（CDVA）、主观视觉功能及钕：钇铝石榴石（Nd:YAG）激光切开术频率的变化情况。
瑞典于默奥市诺尔兰大学医院眼科诊所。
基于人群的前瞻性纵向队列研究。
纳入15年前（1997年至1998年）接受为期1年白内障手术的患者。所有患者在术前、术后4个月以及术后5年、10年和15年回答相同的视觉功能-14（VF-14）问卷。大多数患者（88%；168/190；幸存者的74%）还接受了眼部检查。使用对数最小分辨角对数视力表测量CDVA。
该研究纳入190例患者（占幸存者的83%）。术后15年，术眼的CDVA中位数从术后的20/20下降至20/25（P = 0.0001）。与术后相比，60%的患者CDVA恶化程度小于0.1对数最小分辨角单位。54%（103/190）的患者主观视觉功能（VF-14）无恶化，79%（150/190）的患者下降10分或更少。术前接受Nd:YAG激光囊切开术在手术时年龄小于65岁的患者中更为常见（49%对25%）（P = 0.002）。
该研究证实了白内障摘除术的有效性，为大多数患者提供了良好的长期视力康复。术后15年导致大量功能丧失的最常见合并症是年龄相关性黄斑变性。手术时年龄小于65岁的患者中，有一半在术后15年不需要进行Nd:YAG激光后囊切开术。
作者对文中提及的任何方法或材料均无财务或专利权益。
