超声乳化晶状体摘除治疗合并特发性黄斑前膜的白内障
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Clinical effects of phacoemulsification combined with intraocular lens implantation in patients of cataract with idiopathic macular epiretinal membrane
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    摘要:

    目的:探讨合并特发性黄斑前膜的白内障患者行超声乳化晶状体摘除+人工晶状体植入术的临床疗效。 方法:回顾分析2008-01/2011-10于我院行超声乳化晶状体摘除+人工晶状体植入术的合并特发性黄斑前膜的白内障患者112例118眼,根据临床表现和OCT检查结果按早期、增殖期、牵拉期予以分组,分别于术前、术后1wk;6mo检测患者裸眼视力、最佳矫正视力,OCT检测黄斑中心凹视网膜厚度及视网膜组织变化情况并予以比较。 结果:所有患者术后6mo裸眼视力及最佳矫正视力较术前均有不同程度提高。术后最佳矫正视力早期组≥0.5者100%,增殖期组≥0.5者73%,牵拉期组≥0.1者53%。术后6mo,OCT检测黄斑中心凹视网膜厚度较术前变化均无统计学意义,牵拉期组患者有2例最终行玻璃体切除+黄斑前膜剥离术。 结论:超声乳化晶状体摘除+人工晶状体植入术对于合并特发性黄斑前膜的白内障患者可以改善视觉质量,并不会加重原有眼底病变,是一种安全有效的治疗方法。但对于黄斑前膜已处于牵拉期的白内障患者,单纯白内障手术对术后视力改善有限,建议联合或再行眼底手术治疗。

    Abstract:

    AIM:To explore the clinical effects of phacoemulsification and intraocular lens implantation in patients of cataract with idiopathic macular epiretinal membrane. METHODS: Totally 112 patients (118 eyes) with coexisting cataract and idiopathic macular epiretinal membrane underwent phaco and intraocular lens implantation were analyzed retrospectively covering a period from 2008 to 2011.The patients were divided into three types according to their characteristics and OCT features: the early stage, the proliferative stage, and the traction stage respectively.The visual acuity, the best-corrected visual acuity (BCVA), the central macular thickness and the membrane shape were observed and analyzed before the surgery and at 1 week and 6 months after the surgery. RESULTS:The visual acuity and the BCVA of all the patients were improved more or less 6 months after the surgery . 100% and 73% of the eyes had a BCVA of ≥0.5 in the early stage and the proliferative stage respectively,with 53% of the eyes had a BCVA of ≥0.1 in the traction stage, whereas the central macular thickness had no significant difference. Vitrectomy and internal limiting membrane removal were performed in two patients in the traction group. CONCLUSION:Phacoemulsification and intraocular lens implantation is an effective and safe method for the management of cataract with idiopathic macular epiretinal membrane. The visual quality can be improved,whereas the retinopathy does not worsened.To the patients with cataract and idiopathic macular epiretinal membrane in the traction stage, combined surgery (vitrectomy, internal limiting membrane removal, phaco and intraocular lens implantation) should be performed.

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罗康怡,杜冰,古洵清,等.超声乳化晶状体摘除治疗合并特发性黄斑前膜的白内障.国际眼科杂志, 2012,12(6):1097-1098.

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  • 收稿日期:2012-03-19
  • 最后修改日期:2012-05-07
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