生物以及手术参数对白内障超声乳化术后黄斑中心凹厚度的影响  

Effect of biometric and surgical parameters on central macular fovea thickness after phacoemulsification

作　　者：陈月芹[1] 薛春燕[1] 陈银[1] 朱婷[1] 叶芬[1] 胡钦瑞[1] 黄振平[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)眼科,江苏省南京市210002

出　　处：《眼科新进展》2012年第1期59-61,共3页Recent Advances in Ophthalmology

基　　金：南京军区医药卫生科研基金(编号:07M086)~~

摘　　要：目的评估白内障超声乳化术中的生物以及手术参数对术后黄斑中心凹厚度的影响。方法选取85例(100眼)行白内障超声乳化术联合人工晶状体植入术患者,记录患者的年龄、晶状体核分级、眼轴长度、超声时间、切口累积消散能量(cumulative dissipated energy,CDE)。术前以及术后1个月行光学相干断层扫描测量黄斑中心凹厚度,记录患者术前、术后视力。分析黄斑中心凹厚度与各指标的相关性。结果患者术后裸眼视力、最佳矫正视力(best corrected visual acuity,BCVA)较术前均有明显的提高(P<0.001)。术前黄斑中心凹平均厚度为(154.43±17.43)μm,术后1个月黄斑中心凹平均厚度(182.28±30.78)μm,平均增加(22.85±25.57)μm,差别有统计学意义(P<0.001)。1眼术后2周发生黄斑囊样水肿。黄斑中心凹厚度增加量与核硬度、超声时间、CDE以及眼轴长度呈正相关(分别为P<0.001、P=0.006、P=0.031、P=0.047),但与患者年龄无明显相关性(P=0.386)。术后黄斑中心凹的增加量与BCVA的负对数(LogMAR)呈正相关(r=0.884,P<0.001)。结论白内障超声乳化术后,患者黄斑中心凹厚度有所增加,其与视力的下降有一定的相关性。术后黄斑中心凹厚度增加的因素是多方面的,例如:核硬度、超声时间、CDE和眼轴长度。Objective To evaluate the effect of biometric and surgical parameters on central macular fovea thickness after phacoemulsification.Methods Eighty-five patients（100 eyes） scheduled for phacoemulsification were selected for this clinical trial.The age,nuclear density,axial length,phaco time and cumulative dissipated energy（CDE） were recorded.The postoperative central macular fovea thickness were assessed before and 1 month after operation by optical coherence tomography（OCT）.Results The postoperative uncorrected visual acuity and best corrected visual acuity（BCVA） increased significantly,there were significant differences（all P0.001）.The preoperative average central macular fovea thickness were（154.43±17.43）μm,and which at postoperative 1 month changed into（182.28±30.78）μm with the increase of（22.85±25.57）μm,and the difference was statistically significant（P0.001）.One patient（1 eye） developed cystoid macular edema at postoperative 2 weeks.There were positive relationships between nuclear density,phaco time,CDE,axial length and central macular fovea thickness increase（P0.001,P=0.006,0.031,0.047,respectively）,however,the age was not related（P=0.386）.And the central macular fovea thickness increase showed a positive correlation with postoperative BCVA（LogMAR,r=0.884,P0.001）.Conclusion After phacoemulsification,a mild increase of macular thickness could be observed,which maybe associated with the decreased visual acuity.The central macular fovea thickness increase involves in many factors,such as nuclear density,phaco time,CDE and axial length.

关 键 词：白内障 超声乳化手术 黄斑中心凹厚度 光学相干断层扫描 

分 类 号：R779.66[医药卫生—眼科]