老年白内障在超声乳化术后视盘周围视网膜神经纤维层厚度的变化

The changes of retinal nerve fiber layer thickness of senile cataract patient after phacoemulsification.

目的探讨老年白内障超声乳化吸出术后视盘周围视网膜神经纤维层厚度的变化规律，以了解超声乳化手术对视神经组织的损伤。类型：分层抽样、随机化、同期对照试验。方法年龄相关性白内障19例（29眼），成功施行晶状体超声乳化（Phaco）联合人工晶状体植入手术，分别于术前和术后3d，2周，1个月，3个月，6个月进行光学相干断层扫描（OCT）检查，观察视盘周围视网膜神经纤维层（RNFL）厚度的变化规律，了解Phaco对眼底枧神经的损伤。结果白内障Phaco术前、术后3d、2周、1个月、3个月和6个月视盘周围平均RNFL厚度分别为（94．76±10．71）μm，（98．08±12．62）μm，（101．49±11．27）μm，（101．60±11．54）μm，（101．89±11．09）μm，（99．68±11．61）μm；Phaco术后2周、1个月、3个月与术前比较平均视盘周围RNFL厚度的增加有统计学意义（P值分别为0．027、0．025、0．019）。结论年龄相关性白内障Phaco术后存在视神经的损伤。利用OCT定量测定视盘周围RNFL厚度能观察眼底视神经组织损伤的变化规律。

Objective To investigate the damage of optic nerve tissue of senile cataract patient after phacoemulsification （Phaco） through the menthods of qnantitively evaluating the changes of RNFL thickness. Category including stratified sampling, randomization and concurrent control test. Methods Nineteen examples （29 eyes） of the age-related cataract were chosen randomly. Phacoemulsification and IOL implantation was performed. The changes of RNFL thickness had been quantitively evaluated by optical coherence tomograpby （OCT） just before operation and on the day of 3 days, 2 weeks, 1 month, 3 months and 6 months after operation to investigate the damage of optic nerve tissue of senile cataract patient. Results At the different time points： before operation, 3 days, 2 weeks, 1 month, 3 months, 6 months after operation, the overall mean RNFL thickness was （94.76 ± 10.71 ） μm, （98.08± 12.62） μm, （ 101.49 ± 11.27 ） μm, （101.60±11.54） μm, （101.89±11.09）μm, （99.68 ±11.61 ） μm respectively. The overall mean RNFL thickness at the time points of 2 weeks, 1 month, 3 months after operation was statisticly higher than that before operation （P value was 0. 027, 0. 025,0. 019 respectively）. Conclusions Phaco can influence on the optic nerve tissues of senile cataract patient. To quantitively analysized the RNFL thickness of optic nerve in vivo by using optical coherence tomography can investigate the pathological changes of optic nerve.