山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (4): 97-102.doi: 10.6040/j.issn.1673-3770.0.2022.020

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超声乳化术对老年性白内障黄斑区视网膜结构影响的临床研究

杨茹1,张玉光2,徐湘辉3,吴雪莲3,陶远3,谭越3   

  1. 1.潍坊医学院 临床医学院, 山东 潍坊 261042;
    2.潍坊医学院 临床医学院 眼科学教研室, 山东 潍坊 261042;
    3.济南市第二人民医院 眼科, 山东 济南 250000
  • 发布日期:2022-07-11
  • 通讯作者: 张玉光. E-mail:jnzyg1962@163.com;徐湘辉. E-mail:13969176565@163.com

A clinical study on the effect of phacoemulsification on the retinal structure in the macular region of senile cataract

YANG Ru1, ZHANG Yuguang2, XU Xianghui3, WU Xuelian3, TAO Yuan3, TAN Yue3   

  1. 1. The School of Clinical Medical, Weifang Medical University, Weifang 261042, Shandong, China;
    2. Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang 261042, Shandong, China;
    3.Department of Ophthalmology, The Jinan Second People's Hospital, Jinan 250000, Shandong, China
  • Published:2022-07-11

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摘要： 目的 应用光学相干断层扫描血管成像(OCTA)观察老年性白内障患者超声乳化术后黄斑区血流密度、视网膜厚度和中心凹无血管区(FAZ)面积的变化。探究术中参数对黄斑区结构变化的影响以及探索影响术后视力的因素。 方法 这是一项前瞻性观察研究。老年性白内障患者超声乳化术前及术后1 d、1周、1个月、3个月应用OCTA进行黄斑区3 mm×3 mm自动化扫描,以获得黄斑区血流密度、视网膜厚度及FAZ面积。记录术中累计释放能量(CDE)和有效超声乳化时间(EPT),分析其与黄斑区视网膜结构变化的相关性。应用二分类Logistic回归分析探究影响术后视力的因素。 结果 41例(41眼)纳入最终分析。与术前相比,术后1 d、1周、1个月、3个月黄斑区血管线性密度、灌注密度均增加(P<0.05),FAZ面积均降低(P<0.001);术后1个月、3个月黄斑区视网膜厚度均较术前增加(P<0.05)。术中CDE、EPT与黄斑区视网膜结构变化无相关性(P>0.05),术后最佳矫正视力(BCVA)与黄斑区血流密度、视网膜厚度、FAZ面积、CDE和EPT均无相关性(P>0.05)。 结论 老年性白内障患者超声乳化术后黄斑区血流密度、视网膜厚度增加,FAZ面积降低,手术参数不是引起术后视网膜结构变化的主要因素,手术参数和视网膜结构的变化对术后视力无影响,应当进一步探究术后黄斑区视网膜结构变化的原因以及影响术后视力恢复的因素。

关键词: 光学相干断层扫描血管成像, 超声乳化术, 老年性白内障, 血流密度, 视网膜厚度, 中心凹无血管区

Abstract: Objective Optical coherence tomography angiography(OCTA)is used to observe the changes of blood flow density, retinal thickness, and foveal avascular zone(FAZ)in the macular region after phacoemulsification in patients with senile cataract. The objective of this study is to explore the influence of intraoperative parameters on the structural changes of the macular area and to explore the factors affecting postoperative visual acuity. Methods This is a prospective observational study. Patients with senile cataract who underwent phacoemulsification before operation, and 1 day, 1 week, 1 month, and 3 months after operation, underwent imaging of the macular area using the 3×3 mm OCTA scan to obtain the macular blood flow density, thickness of the retina, and the area of FAZ. Cumulative release energy(CDE)and effective phacoemulsification time(EPT)were recorded, and their correlation with the changes of macular retinal structure was analyzed. Using binary logistic regression analysis to explore the factors affecting postoperative visual acuity. Results Forty-one cases(41 eyes)were included in the final analysis. Compared with those before operation, the linear density and perfusion density of the macular area increased at 1 day, 1 week, 1 month, and 3 months after operation(P<0.05), and the FAZ area decreased(P<0.001); the retinal thickness in the macular increased at 1 month and 3 months after operation compared with preoperative(P<0.05). There was no correlation between CDE and EPT and macular retinal structural changes(P>0.05), and postoperative best corrected visual acuity(BCVA)had no correlation with macular blood flow density, retinal thickness, FAZ area, CDE and EPT(P>0.05). Conclusion After phacoemulsification, the blood flow density and retinal thickness in the macular increased, and the FAZ area decreased. The surgical parameters were not the main factors that caused changes of the postoperative retinal structure. The changes in surgical parameters and retinal structure had no effect on postoperative visual acuity. We should further explore the reasons for the changes of postoperative retinal structure in the macular region and the factors affecting the recovery of postoperative visual acuity.

Key words: Optical coherence tomography angiography, Phacoemulsification, Senile cataract, Blood flow density, Retinal thickness, Foveal avascular zone

中图分类号: 

  • R776.1
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