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超声乳化术对湿性年龄相关性黄斑变性患者视力和黄斑形态的影响。

Effect of Phacoemulsification on Visual Acuity and Macular Morphology in Patients with Wet Age-Related Macular Degeneration.

机构信息

Department of Ophthalmology, Military Institute of Medicine, The Central Clinical Hospital of the Ministry of National Defense, Warsaw, Poland.

出版信息

Med Sci Monit. 2018 Sep 17;24:6517-6524. doi: 10.12659/MSM.909652.

DOI:10.12659/MSM.909652
PMID:30220702
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6154118/
Abstract

BACKGROUND This article discusses the effectiveness of phacoemulsification cataract surgery with intraocular lens implantation in patients with wet age-related macular degeneration in the inactive phase of the disease. MATERIAL AND METHODS Forty-nine patients (50 eyes) aged 78.94±5.54 years, previously treated with intravitreal injections of anti-vascular endothelial growth factor agents, were qualified for a prospective, randomized 12-month study. The participants were divided into 2 groups. Group I consisted of 25 patients (25 eyes) who were subjected to phacoemulsification cataract surgery. Group II consisted of 24 patients (25 eyes) who were not subjected to phacoemulsification cataract surgery despite having a lens opacity of grade II or higher according to the Lens Opacities Classification System. RESULTS After 12 months of follow-up, patients in group I gained on average 8.04 letters (p<0.001). Furthermore, 20% of the eyes had a significant improvement in best corrected visual acuity of ≥15 Early Treatment of Diabetic Retinopathy Study Chart letters. Patients in group II lost on average 1.96 letters (p>0.05). No significant differences between central retinal thickness values in either group (p>0.05) were noted. The mean number of intravitreal injections of anti-vascular endothelial growth factor agents during the study was 2.64±1.98 in group I and 2.92±2.40 in group II (p>0.05). CONCLUSIONS Phacoemulsification performed in eyes with wet age-related macular degeneration during the inactive phase of the disease significantly improves visual acuity. In addition, it does not significantly influence the frequency of intravitreal injections of anti-vascular endothelial growth factor agents or disease activity.

摘要

背景

本文讨论了在疾病非活动期患有湿性年龄相关性黄斑变性的患者中进行超声乳化白内障吸除术联合人工晶状体植入术的效果。

材料和方法

49 名(50 只眼)年龄为 78.94±5.54 岁的患者,此前曾接受过抗血管内皮生长因子药物的玻璃体腔内注射治疗,符合前瞻性、随机 12 个月研究的条件。这些患者被分为 2 组。第 I 组由 25 名患者(25 只眼)组成,他们接受了超声乳化白内障吸除术。第 II 组由 24 名患者(25 只眼)组成,尽管他们的晶状体混浊程度根据晶状体混浊分类系统为 II 级或更高,但未接受超声乳化白内障吸除术。

结果

在 12 个月的随访后,第 I 组患者平均获得了 8.04 个字母(p<0.001)。此外,20%的患者最佳矫正视力提高了≥15 个早期糖尿病视网膜病变研究图表字母。第 II 组患者平均丧失了 1.96 个字母(p>0.05)。两组患者的中央视网膜厚度值无显著差异(p>0.05)。在研究期间,第 I 组患者平均接受了 2.64±1.98 次抗血管内皮生长因子药物的玻璃体腔内注射,第 II 组患者接受了 2.92±2.40 次(p>0.05)。

结论

在疾病非活动期对患有湿性年龄相关性黄斑变性的眼睛进行超声乳化白内障吸除术可显著提高视力。此外,它不会显著影响抗血管内皮生长因子药物的玻璃体腔内注射频率或疾病活动度。

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本文引用的文献

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Clin Sci (Lond). 2017 Dec 4;131(24):2865-2883. doi: 10.1042/CS20171246. Print 2017 Dec 15.
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[PHACOEMULSIFICATION IN EYES WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION (AMD)].[新生血管性年龄相关性黄斑变性(AMD)患者眼中的超声乳化术]
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Switching from pro re nata to treat-and-extend regimen improves visual acuity in patients with neovascular age-related macular degeneration.
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Nan Fang Yi Ke Da Xue Xue Bao. 2019 Apr 30;39(4):500-504. doi: 10.12122/j.issn.1673-4254.2019.04.19.
从按需治疗方案转换为治疗并延长方案可提高新生血管性年龄相关性黄斑变性患者的视力。
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Long-Term Changes in Subfoveal Choroidal Thickness After Cataract Surgery.白内障手术后黄斑中心凹下脉络膜厚度的长期变化
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