Mozaffarieh Maneli, Heinzl Harald, Sacu Stefan, Wedrich Andreas
Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Acta Ophthalmol Scand. 2005 Apr;83(2):176-83. doi: 10.1111/j.1600-0420.2005.00407.x.
To evaluate the visual outcomes (visual acuity [VA] and visual function) after phacoemulsification cataract surgery in patients with diabetic retinopathy (DR), and assess patient satisfaction with final surgical outcome.
This prospective study comprised 74 eyes of 74 patients with different stages of DR. One surgeon (AW) performed all cataract surgery in a standardized fashion. Patients were assessed using the VF-14 (Visual Function-14) questionnaire. The following groups of patients were compared: those with no apparent retinopathy; those with mild non-proliferative DR (NPDR); those with severe NPDR, and those with proliferative DR (PDR). Visual acuity and visual function questionnaire (VF-14) responses were recorded preoperatively and 3 months postoperatively, during which the non-operated fellow eye showed no progression in retinopathy.
Improvements in visual outcomes were significantly higher in groups 1 and 2 compared to groups 3 and 4 (Tukey-Kramer, p < 0.001). Comparisons between groups 1, 2 and 3, 4 showed significant differences in improvements in VA (Tukey-Kramer, p < 0.01), yet no statistically significant differences in functional (VF-14) improvements emerged between these groups.
Patients with more advanced levels of DR showed no functional improvements despite improvements in VA. This emphasizes the relevance of patient education prior to surgery. In particular, it should be explained to patients with more advanced DR that, although surgery may be required, their functional improvement may be limited.
评估糖尿病视网膜病变(DR)患者白内障超声乳化手术后的视觉效果(视力[VA]和视觉功能),并评估患者对最终手术结果的满意度。
这项前瞻性研究纳入了74例不同阶段DR患者的74只眼。由一名外科医生(AW)以标准化方式进行所有白内障手术。使用VF-14(视觉功能-14)问卷对患者进行评估。比较以下几组患者:无明显视网膜病变者;轻度非增殖性DR(NPDR)患者;重度NPDR患者和增殖性DR(PDR)患者。术前和术后3个月记录视力和视觉功能问卷(VF-14)的反应,在此期间,未手术的对侧眼视网膜病变无进展。
与第3组和第4组相比,第1组和第2组的视觉效果改善明显更高(Tukey-Kramer检验,p<0.001)。第1、2组与第3、4组之间的比较显示,VA改善存在显著差异(Tukey-Kramer检验,p<0.01),但这些组之间在功能(VF-14)改善方面无统计学显著差异。
尽管VA有所改善,但DR程度较严重的患者在功能上并无改善。这强调了手术前患者教育的重要性。特别是,对于DR程度较严重的患者,应向他们解释,尽管可能需要手术,但其功能改善可能有限。