超高度近视超声乳化白内障吸出术后黄斑区光学相干断层扫描改变  

Macula changes in patients with super-high myopia after phacoemulsification

作　　者：许莉[1] 刘建巨[1] 张红[1] 谢芳[1] 宋甄[1] 施展[1] 刘平[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院附属眼科医院,中国黑龙江省哈尔滨市150001

出　　处：《国际眼科杂志》2009年第1期52-54,共3页International Eye Science

摘　　要：目的:观察超高度近视患者超声乳化白内障吸出术后黄斑区光学相干断层扫描(optical coherence tomography,OCT)的改变。方法:眼轴≥27mm,屈光度>-10.00D的超高度近视患者27例和单纯老年性白内障患者30例,白内障超声乳化吸出术前及术后1,3mo的黄斑区OCT检查,对比观察手术眼黄斑区OCT图象的变化。结果:超高度近视患者术前及术后1mo黄斑区中心凹神经纤维层的厚度分别是:133±24μm和173±32μm两者比较,差异有统计学意义(t=2.648,P<0.01),术后3mo黄斑区中心凹神经纤维层的厚度138±30μm,与术后1mo的神经纤维层的厚度相比,差异有统计学意义(t=2.794,P<0.01),与术前的神经纤维层的厚度相比,差异无统计学意义(t=1.246)。视网膜厚度的增加与术后视力呈负相关(r=-0.56)。术后OCT检查还发现,黄斑区的全层裂孔1例,视网膜牵拉1例,黄斑区出血1例,黄斑区神经纤维层撕裂1例。单纯老年性白内障超声乳化吸出术前及术后1mo的神经纤维层厚度分别是:147±5μm和149±5μm,两者比较,差异无统计学意义(t=1.0416),术后3mo黄斑区中心凹神经纤维层的厚度150±5μm,与术前及术后1mo的视网膜厚度相比,差异无统计学意义(t=1.034和t=1.316)。结论:超高度近视患者术后1mo大部分发生黄斑区水肿,视网膜厚度明显增加,且视网膜厚度的增加与视力呈负相关。部分患者出现黄斑区的全层裂孔,视网膜牵拉,黄斑区出血,黄斑区神经纤维层撕裂。3mo左右,大部分患者黄斑区水肿消退,并与术前相比无明显差异。AIM ： To observe macula changes in patients with super- high myopia after phacomulsification. METHODS： Twenty-seven super-high myopia patients （ocular axial lenghth ≥27mm, diopter 〉-10.00D） and 30 simple age-related cataract patients were included in this study. The macular area were examined using optical coherence tomography （OCT） at preoperative, 1 and 3 months after phacomulsification, respectively, and the OCT images changes were observed and compared. RESULTS：Preoperative and 1 month after phacomulsification, the mean macular fovea thickness was 133 ± 2413 m and 173 ± 32μ m, with a significant difference （ t = 2.648, P〈 0.01）. And that was 138± 30μm ^3 months after surgery with a significant difference compared with 1 month after surgery （ t = 2. 794, P 〈 0. 01 ）, and without significant difference, while it compared with preorerative （t = 1. 246）. The mean macular thickness in the central fovea showed a negative correlation with visual acuity postoperative（r=-0.56）. After examined by OCT, one case was found with retinal traction by vitreous, 1 case with retinoschisis, 1 case wih macular hole of full layers, and 1 case with macular bleeding. The mean macular fovea thickness of the simple age-related cataract patients was 147 ± 5μm and 149 ±5μm respectively, there was no significant difference （t =1.0416）. And that was 150 ± 5μm^3 month after sugery compared with preoperateive and 1 month after surgery respectively, there was also no significant difference （ t = 1.034; t=1.316）. CONCLUSION, Macular edema is often occurred 1 month afer phacoemulsification. Retinal thickness increases obviously, and shows a negative correlation with visual acuity postoperative. Partial patients present macular hole of full layers, retinal traction, maculau bleeding and retinoschisis. At 3 months, retinal edema disappears and does not show significant difference compared with preoperative.

关 键 词：超高度近视 超声乳化吸出 黄斑区 光学相干断 层扫描 

分 类 号：R779.66[医药卫生—眼科] R774.5[医药卫生—临床医学]