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白内障手术中超声乳化参数对中央视网膜厚度变化的影响。

Impact of Phacoemulsification Parameters on Central Retinal Thickness Change Following Cataract Surgery.

作者信息

Mackenbrock Lars H B, Baur Isabella D, Łabuz Grzegorz, Auffarth Gerd U, Khoramnia Ramin

机构信息

Department of Ophthalmology, University Hospital Heidelberg, 69120 Heidelberg, Germany.

出版信息

Diagnostics (Basel). 2023 Sep 4;13(17):2856. doi: 10.3390/diagnostics13172856.

Abstract

Cataract surgery can lead to inflammatory processes in the retina due to its invasive nature, resulting in prolonged recovery times and reduced functional outcomes. The aim of the current study is to explore the impact that phacoemulsification parameters have on macular thickness following surgery. This prospective single-center study enrolled 46 healthy patients (46 eyes) who underwent uneventful cataract surgery. Retinal thickness was assessed using optical coherence tomography (OCT) preoperatively, as well as 1, 4, and 12 weeks after surgery. The macula was divided into a central (CMT), inner (IMT), and outer ring (OMT). Cataract density was automatically determined using an anterior segment OCT and a custom MATLAB script. Corrected distance visual acuity (CDVA), intraocular pressure (IOP) as well as cumulative dissipated energy (CDE), ultrasound time (UT), and fluids used during phacoemulsification were recorded. Retinal thickness and volume increased significantly following cataract surgery, reaching its maximum 4 weeks post-operatively. Statistically significant correlations were found between the CDE and IMT, OMT and retinal volume change (r = 0.356, r = 0.298, rvolume = 0.357 with < 0.05) as well as between the ultrasound time and IMT, OMT, and retinal volume change (r = 0.369, r = 0.293 and r = 0.409 with < 0.05). Changes in CMT did not correlate with any surgical metrics. Additionally, no correlation was found to the amount of fluid used, whether CDVA or IOP. However, a link between nuclear cataract density and changes in OMT (r = 0.310, < 0.05) was established. How ultrasound energy impacts the choroidea, and to what extent retinal metabolism changes after surgery, needs to be explored in future studies.

摘要

由于白内障手术具有侵入性,可能会导致视网膜发生炎症反应,从而延长恢复时间并降低功能预后。本研究旨在探讨超声乳化参数对术后黄斑厚度的影响。这项前瞻性单中心研究纳入了46例接受了顺利白内障手术的健康患者(46只眼)。术前以及术后1周、4周和12周使用光学相干断层扫描(OCT)评估视网膜厚度。黄斑区被分为中央区(CMT)、内环区(IMT)和外环区(OMT)。使用眼前节OCT和自定义的MATLAB脚本自动测定白内障密度。记录矫正远视力(CDVA)、眼压(IOP)以及超声乳化过程中的累积消散能量(CDE)、超声时间(UT)和使用的液体量。白内障手术后视网膜厚度和体积显著增加,在术后4周达到最大值。发现CDE与IMT、OMT和视网膜体积变化之间存在统计学显著相关性(r = 0.356,r = 0.298,r体积 = 0.357,P < 0.05),以及超声时间与IMT、OMT和视网膜体积变化之间存在相关性(r = 0.369,r = 0.293,r = 0.409,P < 0.05)。CMT的变化与任何手术指标均无相关性。此外,未发现与使用的液体量、CDVA或IOP之间存在相关性。然而,建立了核性白内障密度与OMT变化之间的联系(r = 0.310,P < 0.05)。超声能量如何影响脉络膜以及术后视网膜代谢在多大程度上发生变化,需要在未来的研究中进行探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2c8/10487147/ca1d12d8e205/diagnostics-13-02856-g001.jpg

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