Limoli Paolo Giuseppe, Limoli Celeste, Nebbioso Marcella
Low Vision Research Centre of Milan Milan Italy.
Department of Sense Organs, Faculty of Medicine and Odontology, Rare Retinal Diseases and Ocular Electrophysiology Centre, Umberto I Policlinic Sapienza University of Rome Rome Italy.
Aging Med (Milton). 2024 Dec 13;7(6):802-812. doi: 10.1002/agm2.12386. eCollection 2024 Dec.
Cataracts can reduce the quality of vision in visually impaired patients who already have a visual impairment. The most common causes of low vision include age-related macular degeneration (AMD), high myopia (HM), diabetic retinopathy (DR), glaucoma (GL), and inherited degenerative ocular diseases. The surgery aims to improve their independence, quality of life, and ability to engage in daily, social, and work activities. Phacoemulsification and intraocular lens (IOL) implantation, combined with visual rehabilitation, can improve visual acuity of visually impaired patients. Therefore, comprehensive guidelines for cataract surgery in patients with low vision would be beneficial to ensure optimal surgical outcomes by improving surgical planning, execution, and postoperative care, along with a well-coordinated rehabilitation process. In cases of reduced metabolism, such as low vision, oxidative stress can be aggravated by light exposure and surgical interventions. Thus, maintaining redox balance is crucial for stabilizing retinal conditions. Patients with visual impairments rely on retinal regions with the greatest residual function, and cataract surgery aims to enhance focus on these areas, improving reading quality and reducing scotoma perception. Thorough informed consent is crucial, ensuring that patients are fully aware of the potential risks, benefits, and limitations of surgery. Close postoperative follow-up in the first 6 months is crucial to detect and manage any complications promptly, such as reactivation of maculopathy. The aim of this work is to establish potential guidelines for optimal rehabilitation outcomes through careful literature analysis.
白内障会降低已有视力障碍患者的视觉质量。视力低下的最常见原因包括年龄相关性黄斑变性（AMD）、高度近视（HM）、糖尿病视网膜病变（DR）、青光眼（GL）以及遗传性退行性眼病。该手术旨在提高他们的独立性、生活质量以及参与日常、社交和工作活动的能力。超声乳化吸除术和人工晶状体（IOL）植入术，结合视觉康复，可提高视力障碍患者的视力。因此，针对视力低下患者的白内障手术综合指南将有助于通过改善手术规划、实施和术后护理以及协调良好的康复过程来确保最佳手术效果。在代谢降低的情况下，如视力低下，光照和手术干预会加重氧化应激。因此，维持氧化还原平衡对于稳定视网膜状况至关重要。视力障碍患者依赖于具有最大残余功能的视网膜区域，白内障手术旨在增强对这些区域的聚焦，提高阅读质量并减少暗点感知。充分的知情同意至关重要，要确保患者充分了解手术的潜在风险、益处和局限性。术后前6个月密切随访对于及时发现和处理任何并发症（如黄斑病变复发）至关重要。这项工作的目的是通过仔细的文献分析建立潜在的最佳康复结果指南。
