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眼内植入物和视觉康复改善了老年患者因年龄相关性黄斑变性导致的地图状萎缩的生活质量。

The intraocular implant and visual rehabilitation improve the quality of life of elderly patients with geographic atrophy secondary to age-related macular degeneration.

机构信息

Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic.

Department of Biophysics, Faculty of Medicine, Charles University, Simkova 870, 50003, Hradec Kralove, Czech Republic.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2023 Jan;261(1):263-272. doi: 10.1007/s00417-022-05803-6. Epub 2022 Aug 19.

Abstract

INTRODUCTION

The objective of this prospective study was to evaluate the effects of intraocular macular lens implantation and visual rehabilitation on the quality of life of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

METHODS

Patients with bilaterally decreased near vision (not better than 0.3 logMAR with the best correction), pseudophakia, were included in the project. The Scharioth macula lens (SML) was implanted into the patients' better-seeing eye. Intensive visual rehabilitation of the ability to perform nearby activities was performed for 20 consecutive postoperative days. All subjects were examined before and after SML implantation ophthalmologically. The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was administered before and 6 months after surgery.

RESULTS

Twenty eligible patients with mean age 81 years (63 to 92 years) were included in the project: 7 males and 13 females. Nineteen of them completed the 6-month follow-up. Near uncorrected visual acuity was 1.321 ± 0.208 logMAR before SML implantation and improved to 0.547 ± 0.210 logMAR after 6 months (dz =  - 2.846, p < 0.001, BF = 3.29E + 07). In the composite score of the NEI VFQ-25, there was an improvement in the general score and the specific domains related to the implantation. Participants reported fewer difficulties in performing near activities (dz = 0.91, p = 0.001, BF = 39.718) and upturns in mental health symptoms related to vision (dz = 0.62, p = .014, BF = 3.937).

CONCLUSION

SML implantation, followed by appropriate rehabilitation, improved near vision and increased the quality of life of visually handicapped patients with AMD in our project.

摘要

简介

本前瞻性研究旨在评估眼内黄斑晶状体植入术和视觉康复对年龄相关性黄斑变性(AMD)继发地图状萎缩(GA)患者生活质量的影响。

方法

本项目纳入双眼近视力下降(最佳矫正后不优于 0.3 logMAR)、无晶状体的患者。将 Scharioth 黄斑晶状体(SML)植入患者视力较好的眼内。术后连续 20 天对患者进行近距离活动能力的强化视觉康复。所有患者在 SML 植入前后均进行眼科检查。在手术前后分别使用国家眼科研究所 25 项视觉功能问卷(NEI VFQ-25)进行评估。

结果

该项目共纳入 20 名平均年龄 81 岁(63-92 岁)的符合条件的患者:男性 7 名,女性 13 名。其中 19 名患者完成了 6 个月的随访。SML 植入前未矫正近视力为 1.321±0.208 logMAR,植入后 6 个月提高至 0.547±0.210 logMAR(dz=-2.846,p<0.001,BF=3.29E+07)。在 NEI VFQ-25 的综合评分中,植入相关的一般评分和特定领域的评分均有所提高。患者报告在进行近距离活动时的困难减少(dz=0.91,p=0.001,BF=39.718),与视力相关的心理健康症状改善(dz=0.62,p=0.014,BF=3.937)。

结论

在本项目中,SML 植入术联合适当的康复治疗改善了 AMD 致视力障碍患者的近视力,提高了他们的生活质量。

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