单纯性白内障手术后持续性囊样黄斑水肿的发病情况与处理-苏格兰眼科监测单位研究。

The incidence and management of persistent cystoid macular oedema following uncomplicated cataract surgery-a Scottish Ophthalmological Surveillance Unit study.

机构信息

Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland, UK.

Royal College of Ophthalmologists, London, UK.

出版信息

Eye (Lond). 2021 Feb;35(2):584-591. doi: 10.1038/s41433-020-0908-y. Epub 2020 May 6.

DOI:10.1038/s41433-020-0908-y

PMID:32376978

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7202460/

Abstract

PURPOSE

Post-operative cystoid macular oedema (CMO) can cause deterioration of vision following routine cataract surgery. The incidence of persistent CMO (pCMO; defined as CMO present after 3 months) following uncomplicated surgery is uncertain. We wished to identify the incidence, management and visual outcomes of such patients.

METHODS

A Scottish Ophthalmological Surveillance Unit (SOSU) questionnaire was sent monthly to every ophthalmic specialist in Scotland over an 18-month period from 1st January 2018 asking them to report all new patients with pCMO confirmed on OCT scanning following uncomplicated cataract surgery. A follow-up questionnaire was sent 9 months after initial presentation.

RESULTS

Fourteen cases of pCMO were reported, giving an incidence of 2.2 cases of pCMO per 10,000 uncomplicated cataract surgeries. Mean age was 74.9 years (SD 10.2; range 44-86) with a male preponderance (72.7%). Two patients developed pCMO in each eye. Six cases (46.2%) had hypertension and one had diabetes. Three eyes required intracameral adjuncts (two iris hooks, one intracameral phenylephrine). Postoperative visual acuity (VA) at 3 months was logMAR 0.48 (0.2-0.8). Average mean central retinal thickness (CRT) at 3 months was 497microns (270-788). The most common initial treatment comprised topical steroids and topical NSAIDs (61.5%). Other management strategies included systemic steroids, intravitreal steroids and oral acetazolamide. At 1-year post-op, mean VA was logMAR 0.18 (0.1-0.3) with average mean CRT of 327microns (245-488).

CONCLUSIONS

We identified a low incidence of pCMO following uncomplicated cataract surgery in Scotland (0.02%), with inconsistent and variable management regimes. A nationally agreed treatment protocol is required.

摘要

目的

术后囊样黄斑水肿（CME）可导致常规白内障手术后视力恶化。在无并发症手术后持续性 CME（pCME；定义为手术后 3 个月存在 CME）的发生率尚不确定。我们希望确定此类患者的发生率、治疗方法和视力结果。

方法

在 2018 年 1 月 1 日至 2019 年 6 月期间，苏格兰眼科监测单位（SOSU）每月向苏格兰的每位眼科专家发送一份调查问卷，要求他们报告所有在接受无并发症白内障手术后 OCT 扫描证实为 pCME 的新患者。在初次就诊后 9 个月发送了一份随访问卷。

结果

报告了 14 例 pCME，每 10000 例无并发症白内障手术中 pCME 的发生率为 2.2 例。平均年龄为 74.9 岁（标准差 10.2；范围 44-86），男性居多（72.7%）。两名患者每只眼均发生 pCME。6 例（46.2%）患者患有高血压，1 例患者患有糖尿病。3 只眼需要使用眼内辅助物（2 只虹膜钩，1 只眼内苯肾上腺素）。术后 3 个月时的视力（VA）为 logMAR 0.48（0.2-0.8）。3 个月时平均中央视网膜厚度（CRT）为 497μm（270-788）。最初最常见的治疗方法包括局部皮质类固醇和局部非甾体抗炎药（61.5%）。其他治疗策略包括全身皮质类固醇、眼内皮质类固醇和口服乙酰唑胺。术后 1 年时，平均 VA 为 logMAR 0.18（0.1-0.3），平均 CRT 为 327μm（245-488）。