白内障超声乳化吸除联合人工晶状体植入术后脉络膜厚度变化的研究进展

Progress in the study of choroidal thickness changes after phacoemulsification and intraocular lens implantation

白内障超声乳化吸除联合人工晶状体植入术是目前治疗白内障的首选术式。近年来,随着白内障超声乳化吸除联合人工晶状体植入术的不断完善和成熟,手术后并发症的发生率逐渐降低。但是,部分患者术后视力恢复仍达不到理想的效果。国内外学者普遍认为,这可能与白内障超声乳化吸除联合人工晶状体植入术后视网膜厚度的异常改变有关。脉络膜作为一个高度血管化的组织,为外层视网膜提供氧气及营养物质等,尤其是提供黄斑区的营养和血供。脉络膜厚度变薄或者萎缩,将会严重影响光感受器的功能,甚至导致光感受器细胞死亡。近年来,随着增强深度光学相干断层扫描技术的出现和应用,观察脉络膜各层的细微结构及脉络膜厚度的定点测量在临床上成为可能。相关研究结果表明,白内障术后脉络膜厚度发生不同程度的改变,可能与炎症反应、基因表达、眼内光线的增加及机械牵拉等因素相关。本文就白内障超声乳化吸除联合人工晶状体植入术后脉络膜厚度变化及其影响因素进行综述。

Cataract phacoemulsification combined with intraocular lens implantation is the first choice for the treatment of cataract. In Jin years,with the continuous improvement and maturity of cataract phacoemulsification combined with intraocular lens transplantation, the incidence of postoperative complications has gradually decreased. However,the recovery of visual acuity in some patients is still not satisfactory. Domestic and foreign scholars have suggested that this may be associated with abnormal changes in retinal thickness after cataract phacoemulsification combined with intraocular lens implantation. The choroid as a highly vascularized tissue provides oxygen and nutrients to the outer retina,especially the nutrition and blood supply of macular region. The thickness of the choroid is thinner or atrophy,which will seriously affect the function of the photoreceptor and even lead to the death of the photoreceptor cells. In recent years,with the emergence and application of enhanced optical coherence tomography technology,it is possible to observe the fine structure of choroid layer and the fixed-point measurement of choroidal thickness.Related studies have shown that changes in choroidal thickness after cataract surgery may be related to inflammatory reaction,gene expression,increase of intraocular light and mechanical traction. In this paper,the changes of choroidal thickness and the influencing factors of cataract phacoemulsification combined with intraocular lens implantation were reviewed.