年龄相关性黄斑变性的白内障患者人工晶状体植入术后疗效观察

摘要

目的:观察年龄相关性黄斑变性的白内障患者人工晶状体植入术后疗效.方法:选取我院2012年1月~2015年1月收治的105例(113眼)合并年龄相关性黄斑变性的白内障患者,实施超声乳化白内障摘除人工晶状体植入术治疗,观察其治疗前后视功能及双眼眼底荧光血管造影(FFA)及黄斑部光学相干断层扫描(OCT)检查结果变化.结果:105例患者手术均顺利完成,人工晶状体成功植入,手术时间17~26 min,平均(22.27±6.08)min,患者术后均未见黄斑水肿、视网膜脱离等并发症发生.患者术后1周视力/最佳矫正视力即较术前明显改善,术后1个月~术后6个月逐渐稳定,差异有统计学意义(P<0.05).术后1周~术后1个月,患者年龄相关性黄斑变性分期均较术前逐渐下降,差异有统计学意义(P<0.05).患者术后1周~术后6个月视力均较术前逐渐恢复,差异有统计学意义(P<0.05),患者术前、术后1周、术后1个月、术后3个月、术后6个月黄斑中心凹厚度比较,差异无统计学意义(P>0.05).术后各时期FFA检查均未见黄斑病变加重、黄斑水肿发生.结论:人工晶状体植入术能够有效改善合并年龄相关性黄斑变性的白内障患者的视力状态,且不会导致黄斑中心凹厚度明显变化,其疗效与安全性均值得肯定.%Objective:This study was conducted to observe the efficacy of intraocular lens implantation in cataract patients with age-related macular degeneration. Methods:105 cataract patients (113 eyes) with age-related macular degeneration were enrolled in our hospital from January 2012 to January 2015. Cataract phacoemulsification cataract extraction and intraocular lens implantation were performed to observe the changes of visual function, and the results of fundus fluorescein angiography (FFA) and macular coherence tomography (OCT) before and after treatment. Results:Intraocular lens were successfully implanted in 105 patients. The operation time was 17-26 min and the average time was (22.27±6.08) min. All patients had no complications such as macular edema and retinal detachment. The visual acuity/best corrected visual acuity 1 week after surgery was significantly improved, and gradually got stabilized from 1 month to 6 months after surgery, and the difference was statistically significant between 1 month and 6 months after surgery (P<0.05). The age-related macular degeneration staging was gradually decreased from 1 week to 1 month after surgery, and the difference was statistically significant between 1 week and 1 month after surgery (P<0.05). The visual acuity of the patients were gradually restored from 1 week to 6 months after surgery, the difference was statistically significant between 1 week and 6 months after surgery (P<0.05). The macular fovea thickness of patients before treatment, and at 1 week, 1 month, 3 months and 6 months after surgery were compared, the difference was not statistically significant (P>0.05). Macular degeneration and macular edema were not found in all the periods through FFA examination. Conclusions:Intraocular lens implantation can effectively improve the visual acuity of cataract patients with age-related macular degeneration and will not lead to significant changes in the thickness of macular fovea, and its efficacy and safety are worthy of affirmation.