关键词: 超声乳化, 白内障, 最佳矫正视力, 年龄相关性黄斑变性

Abstract:

Objective      To explore the ratio of age-related macular degeneration(AMD) after cataract phacoemulsification with intraocular lens(IOL)implantation, and analyze the influencial factors of postoperative visual acuity and operational effects on AMD. Methods      300 eyes of cataract phacoemulsification combined with IOL implantation from January 2009 to February 2012 in our hospital were retrospectively analyzed. The uncorrected visual acuity, anterior and posterior segment were checked on 1 day, 1 week, 1 month and 3 months postoperatively and the best corrected visual acuity (BCVA) was examined when necessary. BCVA of all patients were examined 3 months after the operation. The visual acuity, complications and fundus check were recorded. Fundus fluorescein angiography (FFA) was performed when patients were diagnosed or suspected as AMD. Indocyanine green angiography (ICGA) and/or optical coherence tomography (OCT) should be examined if needed. The association studies were performed with SPSS 13.0. Results       1. On day 1 postoperative, there were 45 eyes (15.00%) with BCVA ＜ 0.3 and 255 eyes (85.00%) with BCVA ≥ 0.3. 3 months operative, there were 18 eyes (6.00%) with BCVA ＜ 0.3 and 282 eyes (94.00%) with BCVA ≥ 0.3. 2. After the operation, there were 215 eyes with normal fundus, 56 eyes with AMD, 13 eyes with diabetic retinopathy, 7 eyes with high myopia retinopathy; 3 eyes with retinal vein occlusion; 2 eyes with retinal pigment degeneration, 2 eyes with optic atrophy, 1 eye with macular hole and 1 eye with epiretinal membrane of macular. 3. After cataract surgery, AMD was common in early and intermediate stage but rarely in advanced stage. However, the postoperative visual acuity was better than the preoperative. 4. Before cataract surgery, there were 11 eyes which were diagnosed with cataract and AMD. Except 1 eye developed from early AMD to intermediate stage, the rest did not change obviously after the operation.  The difference was not significant (χ2＝0.234, P=0.890). Conclusion       AMD is the main fundus disease which affects later vision restoration after cataract phacoemulsification and IOL implantation, followed by DR and high myopia retinopathy. The ratio of AMD is 18.67%, which can be commonly noted in early and intermediate stage after cataract surgery. Cataract operation shows no significant effect on the development of AMD but improves the visual acuity.

Key words: Phacoemulsification, Age-related macular degeneration, Cataract, Best corrected visual acuity