应用OCT观察高度近视并发白内障患者超声乳化术后黄斑中心凹厚度变化

Measurement of central foveal thickness in high myopia post-phacoemulsification using optical coherence tomography

摘要:

目的：探讨超声乳化联合人工晶状体植入术的高度近视黄斑区视网膜厚度变化与术后视力的相关性。

方法：随访67例67眼高度近视并发白内障超声乳化术后1wk，1、3mo的最佳矫正视力(BCVA)，并行OCT检查测量黄斑中心凹视网膜厚度(CFT)。于术后3mo根据患者的视力恢复情况分为A组(BCVA>0.5)和B组(BCVA≤0.5)。采用重复测量数据的方差分析后两两比较、Spearman相关分析以及独立样本t检验对数据进行统计分析。

结果：BCVA(LogMAR)术后各时间点较术前均好转且差异有统计学意义(F=115.04，P<0.01)。CFT术前较术后1wk，1mo差异有统计学意义(P=0.04、0.02)，较术后3mo差异无统计学意义(P=0.52)； 术后3mo较术后1wk，1mo增厚，差异均有统计意义(P<0.01)。排除黄斑中心凹病变眼术后3mo的BCVA与CFT在统计学上显著相关(r=0.28，P=0.03)。术后3mo A、B组间CFT差异有统计学意义(t=-2.24，P=0.03)，年龄及人工晶状体度数差异均无统计学意义。

结论：超声乳化联合人工晶状体植入术治疗高度近视并发白内障术后黄斑中心凹区视网膜各层结构的完整及其厚度预示可达到较好的最佳矫正视力。

Abstract:

AIM: To study whether there was a correlation between central foveal thickness(CFT)assessed with optical coherence tomography(OCT)and visual acuity of patient with high myopia after phacoemulsification and intraocular lens implantation.

METHODS: Totally 67 patients with high myopia underwent phacoemulsification and intraocular lens implantation were enrolled in the study. Best corrected visual acuity(BCVA)was recorded and CFT was measured using OCT at 1wk, 1 and 3mo after oerations. BCVA and CFT were compared before and after the operation. All patents were divided into two groups by the BCVA at 3mo after operation, BCVA>0.5 in Group A and BCVA≤0.5 in Group B. ANOVA, Spearman correlation analysis and independent t test were used for statistical analysis.

RESULTS: There was a statistically significant difference between preoperative BCVA and postoperative BCVA(F=115.04, P<0.01). Preoperative CFT was different compared with that 1wk and 1mo after operation(P=0.04, 0.02)and was not different with that 3mo after operation(P=0.52). There was a statistically significant difference in CFT of postoperative 3-month compared with that of postoperative 1-week(P<0.01)or that of postoperative 1-month(P<0.01). BCVA showed significant positive correlation with CFT without foveal lesion on postoperative 3mo(r=0.28, P=0.03). CFT of Group A and Group B was significantly different at 3mo after the operation(t=-2.24, P=0.03). There was no significant difference in age and intraocular lens of two groups.

CONCLUSION: Optical coherence tomography allow for objective assessment of retinal construction changes in eyes with high myopia are correlated to visual acuity.