年龄相关性黄斑病变和白内障患者能从白内障手术中获益吗？
Do patients with age related maculopathy and cataract benefit from cataract surgery?
作者信息
Shuttleworth G N, Luhishi E A, Harrad R A
机构信息
Bristol Eye Hospital.
出版信息
Br J Ophthalmol. 1998 Jun;82(6):611-6. doi: 10.1136/bjo.82.6.611.
AIMS
To assess the benefits of cataract extraction in patients with age related maculopathy (ARM).
METHODS
1073 randomly selected cataract operations were reviewed and 99 cases of preoperatively recognised ARM were identified for investigation. Data relating to visual function were retrieved from case notes, and patient responses to a questionnaire were analysed.
RESULTS
98% had dry or unspecified ARM. Only 2% had exudative maculopathy. 81% of cases had an improvement in best distance acuity; mean change 0.44 logMAR (change of 6/36 to 6/12). 65% responded to the questionnaire; 67% felt that the operation had been worthwhile, 17% had mixed feelings, and 17% thought it not worthwhile.
CONCLUSIONS
This study, which is the first of its kind to be reported, shows a clear benefit from cataract surgery in the majority of patients with ARM. However, the prevalence of ARM in this study is lower than expected, suggesting that some patients with both ARM and cataract were not listed for surgery. The design of a prospective study to quantify the subjective and objective benefits of cataract surgery in these patients is outlined and predictors of successful outcome identified. This will promote the development of guidelines for the surgical management of this group of patients.
目的
评估年龄相关性黄斑病变（ARM）患者白内障摘除术的益处。
方法
回顾1073例随机选择的白内障手术，确定99例术前诊断为ARM的患者进行研究。从病历中获取与视觉功能相关的数据，并分析患者对问卷的回答。
结果
98%的患者患有干性或未明确类型的ARM。只有2%的患者患有渗出性黄斑病变。81%的病例最佳远距离视力有所改善；平均变化0.44 logMAR（从6/36变为6/12）。65%的患者回复了问卷；67%的患者认为手术是值得的，17%的患者感觉复杂，17%的患者认为不值得。
结论
本研究是同类研究中首次报道的，表明白内障手术对大多数ARM患者有明显益处。然而，本研究中ARM的患病率低于预期，提示一些同时患有ARM和白内障的患者未被列入手术名单。概述了一项前瞻性研究的设计，以量化白内障手术对这些患者的主观和客观益处，并确定成功结果的预测因素。这将促进制定该组患者手术管理的指南。
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