高度近视并发白内障手术前后黄斑区OCT观察

Clinical research of macular changes before and after the operation of cataract with high myopia using optical coherence tomography

目的探讨高度近视并发白内障患者行白内障手术对黄斑区视网膜的影响。方法选择屈光度>-8.00 D、眼轴>27 mm的高度近视并发白内障患者47例(50只眼),进行白内障超声乳化联合人工晶状体植入术,记录其术前、术后1周以及术后6周患者的视力及相干光断层扫描(OCT)结果。与对照组单纯老年性白内障患者45例(50只眼)进行比较分析。结果对照组的术后视力明显优于实验组(P<0.05)。实验组患者术前及术后1周神经纤维层的厚度差异有统计学意义(P<0.05),术后6周与术后1周神经纤维层的厚度差异有统计学意义(P<0.05),术后6周与术前神经纤维层的厚度差异无统计学意义(P>0.05)。对照组手术前后神经纤维层厚度差异无统计学意义(P>0.05)。两组中心凹视网膜神经纤维层厚度与术后最佳矫正视力均呈负相关(r=-0.58)。结论高度近视合并白内障患者的白内障术后视力主要取决于黄斑区的改变。

Objective To investigate the effects of cataract surgery for patients with high myopia on the impact of macula. Methods 47 patients（50 eyes） with high myopia（ axis oculi 〉 27 nun, diopter 〉 8.00 D） and cataract were de- tected by giving the optical coherence tomography before, 1 week and 6 weeks after the cataract operation. Compared the 45 senile cataract patients （ 50 eyes ） as control. Results Patients with senile cataract had better postoperative visual acuity （ P 〈 0. 05 ）. The macular nerve fiber layer thickness differences in experiments] group prcoperative and postoperative 1 week had statically significant（ P 〈0.05 ）. The macular nerve fiber layer thickness differences in experimental group postopera- tive 1 week and 6 weeks had statically significant（ P 〈 0. 05 ）. The macular nerve fiber layer thickness differences in exper- imental group preoperative and postoperative 6w had no statlcally significant （ P 〉 0. 05 ）. The macular nerve fiber layer thickness differences in control group preoperative and postoperative had no statically significant（ P 〉0.05 ）. Foveal retinal nerve fiber layer thickness and postoperative best corrected visual acuity were negatively correlated in beth groups （ r = - 0.58 ）. Conclusion The postoperative V A of high myopia depends on macular changes.