超声乳化术对白内障合并特发性黄斑前膜患者黄斑形态的影响  

Influence of phacoemulsification on macular morphology in cataract patients with idiopathic macular epiretinal membrane

作　　者：孔佳慧 霍永军[1] 陈拥军[1] Jia-Hui Kong;Yong-Jun Huo;Yong-Jun Chen(Anyang Eye Hospital, Anyang 455000, Henan Province, China)

机构地区：[1]中国河南省安阳市眼科医院,455000

出　　处：《国际眼科杂志》2022年第4期666-668,共3页International Eye Science

摘　　要：目的:分析白内障合并特发性黄斑前膜(IERM)患者行超声乳化术前后黄斑前膜(ERM)分级、黄斑区形态及最佳矫正视力(BCVA,LogMAR)情况。方法:回顾性病例研究。纳入2016-03/2019-05于我院接受超声乳化术的白内障合并IERM患者51例54眼,分析术前和术后1mo ERM分级、黄斑囊样水肿(CME)、椭圆体带中断和神经上皮层脱离(NSD)的发生及BCVA情况。结果:本组患者术前5眼(9%)ERM 1级,23眼(43%)ERM 2级,21眼(39%)ERM 3级,5眼(9%)ERM 4级;术后1mo ERM分级保持稳定。术后1mo BCVA(0.47±0.17)与术前(0.45±0.16)相比无显著变化(P>0.05),但CME、椭圆体带中断及NSD发生率均较术前显著升高(P<0.05)。结论:超声乳化术并没有显著加快ERM进展和影响BCVA,但显著增加了视网膜黄斑中心凹的炎症反应,故对合并IERM的患者进行白内障手术后需密切随访,如果黄斑区改变影响了BCVA,应尽早行玻璃体切割手术。AIM:To analyze the changes of the epiretinal membrane(ERM)stage,macular status and best corrected visual acuity(BCVA,LogMAR)in cataract patients with idiopathic macular epiretinal membrane(IERM)before and after cataract surgery.METHODS:We conducted a single center retrospective observational case series of patients that underwent sequential cataract and idiopatic ERM surgeries from March 2016 to May 2019 in Anyang Eye Hospital.Full data were obtained for 51 patients(54 eyes).Preoperative and postoperative 1mo ERM stage,central macular edema(CME),central macular thickness(CMT),macular volume(MV),ellipsoid zone disruption,occurrence of neurosensory detachment(NSD)and BCVA were analyzed.RESULTS:In this group of patients,5 eyes(9%)had ERM grade 1,23 eyes(43%)had ERM grade 2,21 eyes(39%)had ERM grade 3,and 5 eyes(9%)had ERM grade 4 before surgery;ERM graded 1mo after surgery were keeping steady.Compared with before operation(0.45±0.16),there was no significant change in BCVA(0.47±0.17)at 1mo after operation(P>0.05),but the incidence of CME,ellipsoid band interruption and NSD were significantly higher than those before operation(P<0.05).CONCLUSION:We suggest that phacoemulsification did not significantly accelerate ERM progression and affect BCVA,but patients underwent cataract surgery in the presence of epiretinal membranes need tight follow up to treat and control eventual macular infammatory changes and eventual prompt vitrectomy if BCVA was threatened.

关 键 词：特发性黄斑前膜 白内障超声乳化手术 视网膜 剥膜 光学相干断层扫描 黄斑区 

分 类 号：R47[医药卫生—护理学]