超声乳化白内障术后黄斑区光学相干断层扫描观察
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R779.6

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中国上海市重点学科建设资助项目(No.S30205)~~


Observation of spectral-domain optical coherence tomography scanning after phacoemulsification cataract surgery
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Shanghai Leading Academic Discipline Project,China(No. S30205)

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    摘要:

    目的:应用三维光学相干断层扫描仪观察白内障术后黄斑区结构的影像学特征。方法:回顾性分析我院2009-11/2010-02行超声乳化白内障手术且术中无并发症的32例46眼单纯老年性白内障患者,记录术后视力、眼前段和眼底情况,术后1mo行三维光学相干断层扫描(Topcon3D OCT-1000)检测。结果:白内障患者46眼均成功施行超声乳化吸除术,术后视力均有不同程度提高;术后1mo从三维OCT中未发现明显黄斑区结构的改变且检测到黄斑中心凹视网膜平均厚度(CMT)为(217.34±36.15)μm,较正常同年龄人群组黄斑中心凹视网膜平均厚度CMT为(195.87±40.87)μm略增加,但两者经统计学处理未见明显差异(P=0.284);少数视力和视功能恢复略差的患者其OCT中表现为光感受器内外节连接(IS/OS)层的连续性及视网膜色素上皮(RPE)的完整性欠佳。结论:无全身及眼部其他疾病的老年性白内障患者,术后1mo黄斑区结构基本与正常人群相同,部分患者出现视网膜后极部IS/OS和RPE连续性和完整性的轻度变化,因而使术后患者视力尤其是视功能质量的提高受到影响。

    Abstract:

    ·AIM:To evaluate the imaging features of the macular after phacoemulsification cataract surgery by spectral-domain optical coherence tomography(SD-OCT).·METHODS:A retrospective series case study.46 eyes with simple age-related cataract who had phacoemulsification from Nov.2009 to Feb.2010 in our hospital without any complications during operation were included in this study.Visual acuity,slit-lamp examination and fundus were checked.SD-OCT(Topcon 3D-OCT-1000)was used to check retinal structure at 1 month after surgery.·RESULTS:Successful cataract surgery was performed in all eyes with postoperative best-corrected visual acuity(BCVA)improved.SD-OCT showed no significant change of the macular thickness except for slight increase of the central macular thickness,which was 217.34±36.15μm compared with195.87±40.87μm of normal people at the same age.There was no statistical difference between surgical group and normal people group.However,the slight abnormal at continuity of the IS/OS layer and integrity of the RPE layer appeared in some poor visual acuity and visual function recovery patients.·CONCLUSION:The macular thickness compared with normal people has no significant change after phacoemulsification in simple age-related cataract patients without other complication before surgery.Some patients at 1 month after surgery with slight poor visual acuity and visual function is probably due to the abnormal of continuity of the IS/OS layer and integrity of the RPE layer.·

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华佩炎,彭清,王诗园,等.超声乳化白内障术后黄斑区光学相干断层扫描观察.国际眼科杂志, 2010,10(8):1503-1505.

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