白内障超声乳化吸出术对黄斑中心小凹厚度的影响

发布时间：2018-08-26 12:52

【摘要】： 目的:利用光学相干断层成像(OCT)对接受白内障超声乳化吸出术后的患眼黄斑部进行扫描,分析白内障超声乳化吸出手术对黄斑中心小凹厚度的影响,及其与黄斑囊样水肿发生率之间的关系。方法:选取64例老年性白内障患者96眼,其中女性患者33例(51眼),男性患者31例(45眼),年龄46～75岁,平均年龄65.23±3.78岁,所有患眼均无其他眼部疾病,且排除高度近视眼,患者无高血压、糖尿病等全身疾病,对于上述患眼行常规白内障超声乳化吸出+人工晶体植入术,于术前、术后1d、1W、2W四个时间段分别应用OCT黄斑部扫描程序对术眼行黄斑中心小凹厚度测量,通过配对t检验进行统计学处理,分析术眼术前及术后各时段黄斑部厚度数值的变化,借此评价白内障超声乳化吸出术对黄斑中心小凹厚度的影响,并将黄斑中心小凹厚度与术后最佳矫正视力、术后屈光度进行相关分析结果: 96例术眼术后最佳矫正视力均达0.5以上,平均术后最佳矫正视力为0.8±0.23,术后2W内术眼术后最佳矫正视力无变化,术后屈光度检查发现术眼术后2W内伴有-0.5DS～-0.75DS近视漂移,平均漂移度为-0.62±0.18DS。OCT扫描显示,术后无一例术眼发生黄斑囊样水肿,测得96例术眼黄斑中心小凹厚度四个时段均值为:术前为176.101μm,术后1d为176.554μm,术后1W为176.502μm,术后2W为179.456μm,将术前、术后1d、术后1W、术后2W四组黄斑中心小凹厚度值予以配对t检验,p值均0.05,即差异无统计学意义,提示术眼黄斑中心小凹厚度在术前与术后无变化。将术后1d、1w、2w,最佳矫正视力与黄斑中心凹厚度相关系数分别为:-0.76、-0.78、-0.72,p0.05,差异有统计学意义。即术后最佳矫正视力与黄斑中心小凹厚度成反比。术后术眼屈光度与黄斑中心小凹厚度相关系数为-0.075,p0.05,即术后屈光度与黄斑中心小凹厚度无相关性。结论:OCT是检测黄斑厚度的有力工具之一,常规白内障超声乳化术后,患眼术后1d、1w、2w黄斑中心小凹厚度与术前相比差异无统计学意义;黄斑中央小凹厚度与超声乳化白内障吸出术后最佳矫正视力相关分析显示在单纯性老年性白内障患者中,最佳矫正视力同黄斑中心小凹厚度呈负相关。术后屈光度与黄斑中心小凹厚度无相关性。目前无临床证据表明,该手术方式可提高黄斑囊样水肿发生的发生率。
[Abstract]:Objective: to study the effect of phacoemulsification on macular fovea thickness after phacoemulsification (phacoemulsification) with optical coherence tomography (OCT). And its relationship with the incidence of macular cystic edema. Methods: 96 eyes of 64 patients with senile cataract were selected, including 33 female patients (51 eyes) and 31 male patients (45 eyes), aged 46 to 75 years, with an average age of 65.23 卤3.78 years. There were no other ocular diseases in all eyes, and high myopia was excluded. Patients without hypertension, diabetes and other systemic diseases, for the above-mentioned eyes phacoemulsification routine phacoemulsification intraocular lens implantation, before the surgery, The macular fovea thickness was measured by OCT scanning program 1 day after operation, and the change of macular thickness before and after operation was analyzed by paired t test. To evaluate the effect of phacoemulsification and phacoemulsification on the thickness of macular central fovea, the thickness of macular central fovea and the best corrected visual acuity were evaluated. The results of correlation analysis of postoperative diopter showed that the postoperative best corrected visual acuity (BCVA) of 96 eyes was above 0.5, the average postoperative BCVA was 0.8 卤0.23.There was no change of BCVA within 2 weeks after operation. The postoperative diopter examination showed that the myopia drift was -0.5DS + -0.75DS within 2 weeks after operation, and the mean drift degree was -0.62 卤0.18DS.OCT scan. There was no postoperative macular cystic edema in any of the eyes. The mean value of macular fovea thickness in 96 eyes was 176.101 渭 m before operation, 176.554 渭 m at 1 day after operation, 176.502 渭 m at 1W and 179.456 渭 m at 2W. The thickness of fovea of macular center in the four groups was matched with t test (0.05) on the 1st day, 1W and 2W after operation, which indicated that the thickness of fovea macula had no change before and after operation, which indicated that there was no significant difference in the thickness of macular central fovea before and after operation. The correlation coefficients between the best corrected visual acuity and the foveal thickness of the macular fovea were: 1: -0.76- -0.78- 0.72p0.05, respectively, and the difference was statistically significant. The best corrected visual acuity was inversely proportional to the fovea thickness. The correlation coefficient between postoperative diopter and macular fovea thickness was -0.075 (p 0.05), that is, there was no correlation between postoperative diopter and macular fovea thickness. Conclusion 1% Oct is a powerful tool for detecting macular thickness. After conventional phacoemulsification, there was no significant difference in macular fovea thickness between 1 day and 2 weeks after cataract phacoemulsification. The correlation analysis between the thickness of central fovea of macular and the best corrected visual acuity after phacoemulsification cataract extraction showed that the best corrected visual acuity was negatively correlated with the thickness of fovea of macular center in patients with simple senile cataract. There was no correlation between postoperative diopter and macular fovea thickness. There is no clinical evidence that this procedure can increase the incidence of macular cystic edema.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66

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