晶状体超声乳化联合人工晶体植入术对合并年龄相关黄斑变性的白内障患者视功能和生存质量的影响  

Influence of Phacoemulsification on the Visual Function and Life Quality of Patients With Cataract Complicated With Age-related Macular Degeneration

作　　者：邵玉红[1] 陈肖[1] 赵海岚[1] 吴苗琴[1] 

机构地区：[1]浙江省人民医院眼科,浙江省杭州市310000

出　　处：《中国全科医学》2015年第17期2038-2042,共5页Chinese General Practice

基　　金：浙江省医药卫生科技计划项目(2009B016)

摘　　要：目的探讨晶状体超声乳化联合人工晶体植入术对合并年龄相关黄斑变性(AMD)的年龄相关性白内障患者视功能和生存质量的影响。方法选取2009年7月—2013年12月于浙江省人民医院治疗的杭州户籍年龄相关性白内障患者710例为研究对象,其中患有年龄相关性白内障,眼部检查可清晰区分AMD分期,2年内无任何眼部手术患者为A组(n=239);患有年龄相关性白内障,眼部检查可清晰区分AMD分期,并行晶状体超声乳化联合人工晶体植入术患者为B组(n=163);患有年龄相关性白内障,眼部检查无AMD,并行晶状体超声乳化联合人工晶体植入术患者为C组(n=308)。分别于研究开始时(B、C组为术前1周)及随访2年后进行log MAR、视功能(VF)和生存质量(QOL)量表测评。结果 3组log MAR,VF量表主观视觉、周边视野、视觉适应、立体视觉和QOL量表自理能力、活动能力、社交能力、心理状态评分提高值比较,差异均有统计学意义(P<0.001),其中,B组log MAR、VF量表各维度和QOL量表各维度评分提高值高于A组(P<0.01),C组log MAR、VF量表各维度和QOL量表各维度评分提高值高于A组和B组(P<0.01)。B组AMD早中期患者log MAR,VF量表主观视觉、周边视野、视觉适应、立体视觉和QOL量表自理能力、活动能力、社交能力、心理状态评分提高值均高于AMD晚期患者,差异有统计学意义(P<0.001)。A组患者由AMD早中期进展为晚期6例,晚期进展率为3.0%(6/200);B组患者由AMD早中期进展为晚期5例,晚期进展率为3.6%(5/139)。两组晚期进展率比较,差异无统计学意义(χ2<0.001,P>0.05)。C组12例患者出现AMD,其中早中期10例(3.2%),晚期2例(0.6%)。结论晶状体超声乳化联合人工晶体植入术是合并AMD的年龄相关性白内障患者长久提高视力、改善VF和QOL的有效手段,且AMD早中期患者术后效果优于AMD晚期患者,并未发现AMD晚期进展率提高。Objective To investigate the influence of phacoemulsification on the visual function and life quality of patients with age-related cataract complicated with age-related macular degeneration（ AMD ）. Methods We enrolled 710 patients with age-related cataract who received treatment in Zhejiang Provincial People′s Hospital from July 2009 to December 2013. We assigned the subjects who had age-related cataract with AMD that could be clearly diagnosed by stage and didn′t received any eye operation in the past two years into group A（n=239）;we assigned the subjects who had age-related cataract with AMD that could be clearly diagnosed by stage,and underwent phacoemulsification into group B（n=163）;we assigned the subjects who had age-related cataract without AMD and underwent phacoemulsification into group C（n=308）. logMAR,VF and QOL assessments were made at baseline（ one week before surgery for group B and group C）and two years later. Results The three groups were significantly different（P〈0. 001）in the increasing values of logMAR,indicators in VF scale（subjective vision,peripheral visual field,visual adaptability,stereoscopic vision）and indicators in QOL scale（ self-care ability,ability of exercise,sociability,psychological status）. Group B was higher（P 〈0. 01）than group A in the increasing values of logMAR,indicators of VF scale and indicators of QOL scale. Group C was higher（P〈0. 01）than group A and group B in the increasing values of logMAR,indicators of VF scale and indicators of QOL scale. In group B,the subjects with AMD of early or middle stage were higher（ P 〈0. 01 ） than the subjects with AMD of advanced stage in the increasing values of logMAR, indicators in VF scale（ subjective vision,peripheral visual field,visual adaptability,stereoscopic vision）and indicators in QOL scale（ self -care ability,ability of exercise,sociability,psychological status）. In group A,6 subjects with AMD of early or middle stage progressed into advance stage with a rate of

关 键 词：白内障 黄斑病 年龄相关 超声乳化白内障吸除术 视功能 生活质量 

分 类 号：R776.1[医药卫生—眼科]