【摘要】 目的评价白内障超声乳化联合人工晶体植入术对伴有黄斑前膜的白内障患者的疗效。方法选取2011—2012年间在上海和平眼科医院行白内障超声乳化联合人工晶体植入术的患者68例74眼,术前根据黄斑区光相干断层扫描(OCT)图像,将患者分为单纯黄斑前膜组(黄斑前膜组,48眼)和黄斑前膜合并其他黄斑疾病组(其他黄斑疾病组,26眼)。分别于术后1周和1、6个月进行门诊随访,检查并记录所有患者术前和术后6个月验光得到的最佳矫正视力,以最小分辨角的对数(LogMAR)表示。术后6个月再行黄斑区OCT检查,并与术前检查结果进行比较。结果两组术后LogMAR值均显著小于同组术前(P值均<0.05),黄斑前膜组手术前后LogMAR差值显著小于其他黄斑疾病组(P<0.05)。术后6个月随访时,两组黄斑前膜的形态较术前均无明显改变,视网膜的厚度、玻璃体黄斑交界面形态较术前亦无明显改变。其他黄斑病变组中合并的黄斑裂孔形态、黄斑劈裂高度、脉络膜视网膜萎缩范围等较术前均无进一步发展。结论对合并单纯黄斑前膜的白内障和除黄斑前膜外合并其他黄斑疾病的白内障患者行超声乳化白内障联合人工晶状体植入术后,最佳矫正视力均可提高,前者术后最佳矫正视力提高优于后者。更多还原

【Abstract】 Objective To evaluate the efficacy of phacoemulsification and intraocular lens implantation to cataract patients with macular epiretinal membrane.Methods A total of 68 cataract patients(74 eyes)undergoing phacoemulsification and intraocular lens implantation between 2011 and 2012in our hospital were enrolled in this study.According to macula optical coherence tomography(OCT)images,they were divided into simple epiretinal membrane group(48eyes)and epiretinal membrane combined with other macular disease group(other macular disease group,26eyes).Outpatient follow-up was conducted 1week and 1month,6months after surgery.The best corrected visual acuity of all patients was checked before surgery and 6months after surgery.The results were recorded by the minimum angle of resolution(LogMAR).Macular OCT images were recorded 6months after surgery and compared with preoperative one.Results Postoperative LogMAR was significantly lower than preoperative one in both groups(both P <0.05).The difference between preoperative and postoperative LogMAR in macular membrane group was significantly lower than that in other macular disease group(P<0.05).No significant changes were found in the appearance of macular epiretinal membrane,the thickness of the retina or the appearance of vitreous macular interface 6months after surgery.Macular hole,macular splitting height,choroidal retinal atrophy had no further progression in the other macular disease group after surgery.Conclusion The phacoemulsification combined with intraocular lens implantation can effectively improve the best corrected visual acuity in cataract patients with macular epiretinal membrane or other macular disease.The restoration of visual acuity is closely related to pathological changes of macular region.更多还原