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目的运用相干光断层扫描术(OCT)研究无手术并发症的白内障患者在行白内障超声乳化摘除联合人工晶状体植入术后低视力的临床情况。方法前瞻性临床研究。共连续纳入2014年4月至2016年4月于上海市静安区市北医院白内障超声乳化摘除联合人工晶状体植入术,术中未发生手术并发症,术后1个月的最佳矫正视力<0.3的患者72例(72只眼),于术后1个月进行随访,记录最佳矫正视力(BCVA),并于术后1个月行OCT检查。结果入选患者的平均年龄为78.2岁。患者术后1个月BCVA小于0.3者占5.1%。OCT检查提示,导致患者术后低视力的原因有高度近视性脉络膜视网膜病变、老年性黄斑变性、糖尿病性视网膜病变、黄斑水肿、黄斑前膜、视网膜劈裂症、黄斑孔、视网膜色素变性。Logistic回归模型提示患者年龄是照成术后1个月低视力的危险因素。结论在本研究中,术后1个月OCT检查有助于了解患者术后低视力的原发病。
Objective To study the clinical features of cataract patients without cataract after cataract extraction by phacoemulsification combined with intraocular lens implantation by using coherent light tomography (OCT). Methods Prospective clinical study. A total of consecutive included in April 2014 to April 2016 in Shanghai Jing’an District, Beijing Hospital cataract phacoemulsification combined with intraocular lens implantation, surgical complications did not occur during surgery, 1 month after the best corrected visual acuity < 0.3 of 72 patients (72 eyes), were followed up 1 month after surgery, recording the best corrected visual acuity (BCVA), and 1 month after the OCT examination. Results The mean age of patients enrolled was 78.2 years. Patients with BCVA of less than 0.3 accounted for 5.1% at 1 month after operation. OCT examination suggests that the causes of postoperative low vision in patients with high myopia chorioretinopathy, age-related macular degeneration, diabetic retinopathy, macular edema, macular degeneration, retinal splitting, macular hole, retinitis pigmentosa. Logistic regression models suggest that patient age is a risk factor for low vision at 1 month after surgery. Conclusion In this study, OCT examination one month after surgery was helpful to understand the primary disease of postoperative low vision.