光学相干断层成像术观察超声乳化白内障吸除术后黄斑变化

目的　探讨超声乳化白内障吸除术后黄斑形态的变化及其可能的影响因素。方法　对行超声乳化白内障吸除术 ,且术前无合并症、术中无并发症发生的单纯老年性白内障患者 80例 (80只眼 )于术前和术后 1周分别行光学相干断层成像术 (opticalcoherencetomography ,OCT)检查 ;按术中使用的超声能量高低分成 2个组。观察黄斑中心凹视网膜厚度的变化及其与术中超声能量、术后前房炎性反应和视力的关系。结果　 80只眼黄斑中心凹视网膜平均厚度术前为 (14 2 9± 16 7) μm ,术后为 (15 7 9± 36 7) μm ,两者比较差异无显著意义 (P >0 0 5 )。术后 3只眼出现黄斑水肿 ,11只眼出现房水中度闪光 ,黄斑中心凹视网膜平均厚度术前为 (139 9± 11 3) μm ,术后为 (197 6± 36 9) μm ,两者比较差异有显著意义 (t =2 75 1,P <0 0 5 )。低能量组术后黄斑中心凹视网膜平均厚度为 (15 6 2± 18 3) μm ,高能量组为 (172 6± 32 9) μm ,两者比较差异有显著意义 (t=2 4 11,P <0 0 5 )。术后最佳矫正视力与黄斑中心凹视网膜厚度呈负相关性 (r=- 0 82 ,P <0 0 5 )。结论　超声乳化白内障吸除术可导致术眼黄斑中心凹视网膜厚度增加及黄斑水肿 ;术中高超声能量可明显影响术后黄斑中心凹视网膜的形态 ;术后黄斑中心

Macular image changes of optical coherence tomography after phacoemulsification

OBJECTIVE: To investigate the effects of phacoemulsification on the macula following uncomplicated phacoemulsification by optical coherence tomography (OCT). METHODS: Eighty eyes of the senile cataract were chosen randomly. The uncomplicated phacoemulsification was performed. OCT was examined preoperatively and 1 week after the surgery. Preoperative visual acuity, the retinal thickness and phaco power were compared with those after surgery. RESULTS: In 80 eyes, the preoperative mean foveal thickness was (142.9 +/- 16.7) micrometer and the postoperative (157.9 +/- 36.7) micrometer, the difference being not significant (P > 0.05). Three eyes had macular edema 1 week after surgery. In 11 eyes with Tyndall sign (+ +), the mean postoperative foveal thickness was thicker than the mean preoperative value (P < 0.05). In lower phaco power group, the mean postoperative foveal thickness was (156.2 +/- 18.3) micrometer and the higher phaco power group was (172.6 +/- 32.9) microm (P < 0.05). The best corrected visual acuity after surgery had a negative correlation with the retinal thickness. CONCLUSIONS: The retinal thickening and macular edema can be found after uncomplicated phacoemulsification. The higher phaco power results in significant inflammation and thicker retina. The visual consequences were proportional to the degrees of macular thickening.