Department of Ophthalmology, University of Perugia, Ospedale S. Maria della Misericordia, S. Andrea delle Fratte, Perugia, Italy.
Curr Eye Res. 2009 Dec;34(12):1036-41. doi: 10.3109/02713680903288937.
To examine macular changes before and after uncomplicated cataract surgery in a healthy population.
In a prospective study, we evaluated 62 eyes of healthy patients having elective cataract phacoemulsification. We performed optical coherence tomography (OCT) measurements preoperatively and at 3, 6, 12, 20, and 28 weeks after surgery. The retinal map was divided into minimal foveal thickness, a central 1-mm disk area, and two peripheral ring areas with diameters of 3 mm and 6 mm, respectively, and centered on the fovea. We compared the postoperative OCT values against the respective preoperative values.
Two eyes (3.2%) developed cystoid macular edema (CME) after cataract surgery and were excluded from the study. With respect to preoperative values, visual acuity improved significantly postoperatively, and at 12 weeks, we observed an asymptomatic increase in retinal thickness at 3 mm and 6 mm. Macular volume showed a statistically significant increase at the 12th week after surgery. There was no correlation between macular changes and best corrected visual acuity (BCVA) or ultrasound time.
Our data indicate that the onset of clinically significant CME is rare after uncomplicated phacoemulsification cataract surgery, but with respect to preoperative values we observed an asymptomatic increase in macular thickness and volume at 12 weeks. The possible onset of macular alterations after uncomplicated cataract surgery must be taken into account as a potential later complication, because it can lead to a permanent loss of visual acuity.
观察健康人群单纯性白内障手术后黄斑的变化。
前瞻性研究中,我们评估了 62 例行白内障超声乳化吸除术的健康患者的 62 只眼。我们在术前和术后 3、6、12、20 和 28 周分别进行光学相干断层扫描(OCT)测量。视网膜图谱分为最小黄斑中心凹厚度、中央 1mm 盘区和以黄斑中心为中心的直径分别为 3mm 和 6mm 的两个外周环区。我们将术后 OCT 值与各自的术前值进行比较。
术后 2 只眼(3.2%)发生囊样黄斑水肿(CME),被排除在研究之外。与术前值相比,术后视力显著提高,术后 12 周时,我们观察到 3mm 和 6mm 处视网膜厚度出现无症状性增加。术后 12 周黄斑体积呈统计学显著增加。黄斑变化与最佳矫正视力(BCVA)或超声时间之间无相关性。
我们的数据表明,单纯性超声乳化白内障吸除术后发生临床显著 CME 的发生率较低,但与术前值相比,我们观察到术后 12 周黄斑厚度和体积出现无症状性增加。单纯性白内障手术后黄斑改变的可能发生必须被视为一种潜在的迟发性并发症,因为它可能导致永久性视力丧失。