Taipale Claudia, Grzybowski Andrzej, Tuuminen Raimo
Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.
Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.
Ann Transl Med. 2020 Nov;8(22):1543. doi: 10.21037/atm-2020-965.
To determine whether patients with severe vision impairment due to advanced age-related macular degeneration (AMD) benefit from bilateral cataract surgery in terms of vision-related quality of life (QoL).
A prospective interventional single-center study. Ten patients with severe vision impairment due to advanced bilateral AMD were included. The preoperative corrected distance visual acuity (CDVA) was ≥1.0/≥1.0 LogMAR units on Snellen chart and <20/<20 points on Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Patients were not on active treatment for wet AMD as the treatment was expected to have no effect or benefit. The patients were scheduled for immediate sequential bilateral cataract surgery, with target refraction emmetropia (SN60WF, Alcon). Vision-related QoL was measured with National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) preoperatively, at 3 months and 1 year.
The mean age of the patients was 82.5±6.2 years. The mean NEI VFQ-25 overall composite score changed from 44.0±7.1 preoperatively to 54.9±13.7 at 3 months and to 56.9±15.6 at 1 year (P=0.045, Friedman test). During the 1-year follow-up, there was an improvement in the subscale scores indicating difficulty with peripheral vision, mental health symptoms, and role difficulties due to vision (P<0.05 for all, Wilcoxon sign-rank test).
Cataract surgery may improve the vision-related QoL in patients with severe vision impairment due to bilateral advanced AMD.
确定因晚期年龄相关性黄斑变性（AMD）导致严重视力损害的患者在视力相关生活质量（QoL）方面是否能从双侧白内障手术中获益。
一项前瞻性干预性单中心研究。纳入10例因晚期双侧AMD导致严重视力损害的患者。术前矫正远视力（CDVA）在Snellen视力表上≥1.0/≥1.0 LogMAR单位，在早期糖尿病视网膜病变研究（ETDRS）视力表上<20/<20分。由于预期治疗无效果或益处，患者未接受湿性AMD的积极治疗。患者计划接受即刻序贯双侧白内障手术，目标屈光为正视眼（SN60WF，爱尔康）。术前、术后3个月和1年使用美国国立眼科研究所视觉功能问卷-25（NEI VFQ-25）测量视力相关生活质量。
患者的平均年龄为82.5±6.2岁。NEI VFQ-25总体综合评分的平均值从术前的44.0±7.1变为术后3个月的54.9±13.7，以及术后1年的56.9±15.6（Friedman检验，P=0.045）。在1年的随访期间，表明周边视力困难、心理健康症状以及因视力导致的角色困难的子量表评分有所改善（所有P<0.05，Wilcoxon符号秩检验）。
白内障手术可能改善因双侧晚期AMD导致严重视力损害患者的视力相关生活质量。
