[手持式视网膜验光仪和光学相干断层扫描对特发性黄斑视网膜前膜白内障患者术后视力的预测]
[Prediction of postoperative visual acuity in cataract patients with idiopathic macular epiretinal membrane by hand-held retinal optometer and optical coherence tomography].
作者信息
Li Hongyang, Li Yanying, Xue Liping, Zou Honglei, Liang Renlong, Yang Binghua, Wu Yi
机构信息
Department of Ophthalmology, Guangdong Second Provincial People's Hospital, Guangzhou 510310, China.
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2021 Jan 30;41(1):123-127. doi: 10.12122/j.issn.1673-4254.2021.01.18.
OBJECTIVE
To investigate the value of hand-held retinal optometer and optical coherence tomography (OCT) in predicting postoperative visual acuity in patients with age-related cataract and idiopathic macular epiretinal membrane.
METHODS
We retrospectively analyzed the data of patients undergoing phacoemulsification combined with intraocular lens implantation for age-related cataract in our hospital from January, 2019 to April, 2020.Preoperative examination detected idiopathic macular epiretinal membrane in 45 of the patients (52 eyes) with lens opacity grade C2N2P1 according to LOCSⅡ lens opacity classification criteria.Based on the thickness of the macular fovea, the eyes were divided into group A (9 eyes) with macular thickness < 300 μm by OCT examination, group B (25 eyes) with macular thickness of 300 to 400 μm, and group C (18 eyes) with macular thickness >400 μm.The best corrected visual acuity and retinal visual acuity before operation and the best corrected visual acuity on the first day and at 3 months after the surgery were compared among the 3 groups.The consistency between the preoperative retinal vision and the best corrected vision at 3 months after the surgery was analyzed.
RESULTS
The best corrected visual acuity at one day and 3 months after the surgery differed significantly from that before the surgery in all the 3 groups ( < 0.05).The best corrected visual acuity recovered to 0.3-0.5 in most of the patients in the 3 groups. Thirty-one (91.18%) of the patients with a macular thickness less than 400 μm had a visual acuity≥0.3 after cataract surgery, as compared with only 14 patients (77.78%) among those with a macular thickness >400 μm.There was a positive linear correlation between preoperative retinal visual acuity and best corrected visual acuity at 3 months after the surgery (=0.830, < 0.05).
CONCLUSIONS
For patients with cataract and idiopathic macular epiretinal membrane, phacoemulsification combined with intraocular lens implantation can improve postoperative vision.Hand-held retinal optometer can accurately assess postoperative vision in patients with stage C2N2P1 cataract.Patients with a macular thickness >400 μm caused by idiopathic macular epiretinal membrane are likely to have poor postoperative visual outcomes.
目的
探讨手持视网膜验光仪及光学相干断层扫描（OCT）在预测年龄相关性白内障合并特发性黄斑视网膜前膜患者术后视力中的价值。
方法
回顾性分析2019年1月至2020年4月在我院接受年龄相关性白内障超声乳化联合人工晶状体植入术患者的数据。术前检查根据LOCSⅡ晶状体混浊分类标准，在45例（52只眼）晶状体混浊分级为C2N2P1的患者中检测出特发性黄斑视网膜前膜。根据黄斑中心凹厚度，将患眼分为A组（9只眼），OCT检查黄斑厚度<300μm；B组（25只眼），黄斑厚度为300～400μm；C组（18只眼），黄斑厚度>400μm。比较3组患者术前最佳矫正视力、视网膜视力以及术后第1天和术后3个月时的最佳矫正视力。分析术前视网膜视力与术后3个月最佳矫正视力之间的一致性。
结果
3组患者术后第1天和术后3个月时的最佳矫正视力与术前相比差异均有统计学意义（<0.05）。3组中大多数患者的最佳矫正视力恢复到了0.3 - 0.5。黄斑厚度<400μm的患者中有31例（91.18%）白内障术后视力≥0.3，而黄斑厚度>400μm的患者中只有14例（77.78%）。术前视网膜视力与术后3个月最佳矫正视力之间呈正线性相关（=0.830, <0.05）。
结论
对于白内障合并特发性黄斑视网膜前膜患者，超声乳化联合人工晶状体植入术可改善术后视力。手持视网膜验光仪可准确评估C2N2P1期白内障患者术后视力。特发性黄斑视网膜前膜导致黄斑厚度>400μm的患者术后视力预后可能较差。
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