应用频域光学相干断层扫描比较超声乳化白内障吸除术及小切口白内障摘除术术后黄斑厚度

目的 应用三维光学相干断层扫描仪分析比较超声乳化白内障吸除术和小切口白内障摘除术两种手术方式术后黄斑区的厚度,并探讨两种手术方式对黄斑区的厚度所产生的影响的可能机制.方法 回顾性分析我院2012年9月至2013年3月行白内障手术且术中无并发症的患者共83人84眼,将其中行超声乳化白内障手术38例患者39眼设为A组,行小切口白内障摘除手术的45例45眼患者设为B组,记录术后视力、眼前段和眼底情况,术后1天行三维光学相干断层扫描（Topcon3D OCT-1000）检测.结果 A组患者成功施行超声乳化吸除术,B组患者成功施行小切口白内障摘除手术,术后视力均有不同程度提高,术后1天从三维OCT中均未发现明显黄斑区结构的改变,检测到A、B两组黄斑中心凹1mm视网膜平均厚度分别为（236.14±30.41）μm、（223.11±32.10）,较正常同年龄人群组黄斑中心凹1mm视网膜平均厚度（229.0±20.46）μm略增厚,且无统计学意义：A组（P=0.224）,B组（P=0.286）.两组距黄斑中心凹3～6mm的外环区上、下、颞、鼻4个象限的视网膜厚度与正常同年龄人群组相比均增厚,差异有统计学意义（P均＜0.05：A组黄斑外环上、颞、下、鼻侧视网膜平均厚度为（256.58±14.93）、（243.71±16.06）、（259.92±21.14）、（275.79±16.78）;B组黄斑外环上、颞、下、鼻侧视网膜平均厚度为（256.93±19.43）、（243.29±20.54）、（259.43±23.52）、（275.43±21.47）,正常同年龄人群组黄斑外环上、颞、下、鼻侧视网膜平均厚度为（247.00±13.68）、（232.50±16.51）、（243.2±13.85）、（268.5±15.59）.两组黄斑中心凹1mm视网膜平均厚度、距黄斑2～3mm内环视网膜厚度、外环视网膜厚度、视网膜体积及视网膜平均厚度相比较均无统计学意义.结论 无全身及眼部其他疾病的白内障患者行超声乳化白内障吸除术或小切口白内障摘除术术后短期内距黄斑中心凹3～6mm的外环区4个象限的视网膜厚度与正常同年龄人群组相比均增厚,但两种手术方式对比并未见有差异.

Application of Frequency domainOptical Coherence Tomography ultrasound for comparethe thickness of macula luteaafter phacoemulsification and small incision extracapsular cataract extraction surgery

Objective Using three-dimensional Optical Coherence Tomography to analyse and compare the retinalmacular thickness of patients who received operation of phacoemulsification or small incision extracapsular cataract extraction, as well as to discuss the possible mechanisms. Methods Eighty-three cases （eighty-four eyes） of cataract patients received operation in our hospital duringSeptenmber2012 and March2013 were divided into two groups, groupA （39 eyes） received phacoemulsification whilegroupB （45 eyes） received small incision extracapsular cataract extraction, recordingvision, reflection of anterior segment and ocular funduspostoperative, detected the thicknessof retinalmacular with OCT （ Topcon3D OCT-1000 ） at the first daypostoperative. Results Sight for all patients get better after they received operation. Average retinal macularthicknesses of groupAwas （236.14 ＋ 30. gl ） ~m, and groupB was （ 223. 11 ＋ 32. 10 ） ~m. Compared to normal people （229.0 ＋ 20.46） ~m, the differences present no statistically significant （ PA = 0. 224, PB = 0.286）. Retinal thicknessesfor four quadrants of outer ring of fovea centralis （3 -6mm） of the two groups were thickerthan normal group, the differences present statistically significant （P 〈 0. 05 ）. Retinal macular thicknessesat the four quadrants（ superior, temporal, inferior and nasal ） for groupA were （ 256.58 ＋ 14. 93 ）, （ 243.71 ＋ 6.06 ）, （259.92 ＋21. 14）, （275.79 ~ 16.78） ~m separately;And for group B were （256.93 ＋ 19.43）, （243.29 ~ 20.54）, （259.43 -＋ 23.52 ）, （ 275.43 ＋ 21.47 ） ~m separately; For normal people were （ 247.00 ＋ 13.68 ）, （232.50 ~ 16.51 ）, （243.2 ＋- 13.85 ）, （ 268.5 ~ 15.59 ） ~mseparately. Difference between two groups both on average retinal thicknesses of center macular （ 1 mm）, four quadrants retinal thicknesses of inner ring of fovea centralis（ 1 -3ram）and four quadrants retinal thicknesses of outer ring of fovea centralis （3 -6mm）present no statistically significant （P 〉 0. 05）. Conclusions Retinal thicknessesat all districton for patients,with no systemic and ocular disease, experienced surgery of phacoem~sification or small incision extracapsular cataract extraction were thicker than normal group ,but the differences between them present no statistically significant（ P 〉 0.05 ）.