Yılmaz Tolga, Karci Ayse Aslihan, Yilmaz İhsan, Yılmaz Ahu, Yıldırım Yusuf, Sakalar Yildirim Bayezit
Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, İstanbul, Turkey.
Department of Ophthalmology, Derince Training and Research Hospital, Kocaeli, Turkey.
Med Sci Monit. 2016 May 9;22:1566-70. doi: 10.12659/msm.898714.
BACKGROUND Cataract surgery is associated with the development of late-onset age-related macular degeneration (AMD). The pathogenic mechanism is still not fully established. The purpose of this study was to evaluate the possible changes in central macula thickness (CMT) and subfoveal choroid thickness (SCT) after uneventful cataract surgery. MATERIAL AND METHODS A total of 65 eyes of 65 patients who underwent phacoemulsification and intracapsular lens implantation were included in this prospective study. Patients had not undergone previous ocular surgery and had no other ocular abnormality. CMT and SCT were measured at baseline and postoperatively at week 1 and months 1, 3, 6 and 12 via spectral domain optical cohorence tomography (SD-OCT). RESULTS CMT was 252.4±27.6 μm (mean ±SD) preoperatively, then 253.5±29.8, 256.1±28.7, 257.4±27.2, 253.18±23.7, and 252.8±21.7 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. There were insignificant changes in CMT, and it returned to baseline at six months after surgery (all p>0.05). SCT was 237.4±21.6 μm preoperatively, and 240.5±24.8, 241.2±25.7, 242.7±26.3, 243.1±24.2, and 244.2±21.4 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. Although there was an increase in SCT during follow-up, the difference between preoperative and postoperative values was not significant (p>0.05). CONCLUSIONS Uncomplicated phacoemulsification induces subclinical changes in CMT, probably due to the inflammatory insult of surgery, and CMT returns to baseline value. There were slight, insignificant increases in choroid thickness during follow-up, and this did not return to baseline during follow-up. Changes in the choroid after cataract surgery may provide clues to the development of late-onset AMD.
背景 白内障手术与迟发性年龄相关性黄斑变性(AMD)的发生有关。其致病机制仍未完全明确。本研究的目的是评估白内障手术顺利完成后中心黄斑厚度(CMT)和黄斑中心凹下脉络膜厚度(SCT)的可能变化。
材料与方法 本前瞻性研究纳入了65例行超声乳化白内障吸除术及囊内人工晶状体植入术患者的65只眼。患者既往未接受过眼部手术,且无其他眼部异常。通过频域光学相干断层扫描(SD-OCT)在基线时以及术后第1周、术后1、3、6和12个月测量CMT和SCT。
结果 术前CMT为252.4±27.6μm(平均值±标准差),术后第1周、术后1、3、6和12个月分别为253.5±29.8、256.1±28.7、257.4±27.2、253.18±23.7和252.8±21.7μm。CMT变化不显著,术后6个月恢复至基线水平(所有p>0.05)。术前SCT为237.4±21.6μm,术后第1周、术后1、3、6和12个月分别为240.5±24.8、241.2±25.7、242.7±26.3、243.1±24.2和244.2±21.4μm。尽管随访期间SCT有所增加,但术前和术后值之间的差异不显著(p>0.05)。
结论 单纯超声乳化白内障吸除术可引起CMT的亚临床变化,可能是由于手术的炎症刺激所致,且CMT会恢复至基线值。随访期间脉络膜厚度有轻微、不显著的增加,且随访期间未恢复至基线水平。白内障手术后脉络膜的变化可能为迟发性AMD的发生提供线索。