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頁籤選單縮合
題 名 | 高度近視患者白內障手術視力預後與相關危險因子之探討=The Visual Outcome and Related Parameters in Cataract Surgery with High Myopia |
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作 者 | 張庭嘉; 郭麗琳; 劉秀雯; 翁林仲; 周碧瑟; 蔡景耀; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷 期 | 46:1 2007.03[民96.03] |
頁 次 | 頁27-33 |
分類號 | 416.744 |
關鍵詞 | 高度近視; 白內障; 視力不良; Cataract surgery; Diabetes mellitus; High myopia; Maculopathy; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:本研究探討臺灣地區合併有高度近視之白內障患者,於接受白內障手術之後其視力之預後,以及造成術後視力不良的相關危險因子之觀察,並且評估這群患者產生術後併發症之頻率。 方法:本篇報告為回溯性、無配對比較型的研究,病患來源為一區域教學醫院眼科。我們定義高度近視之眼軸長必須大於或等於26.0mm。主要研究標的為術後六個月之視力與視覺品質,以及術後之併發症。 結果:自2002年1月至2004年12月我們收集了52隻高度近視之患眼。平約追蹤時間為33.3周。32隻眼 (61.5%) 其視力獲得顯著改善(定義為術後最佳矯正視力於Snellen視力表進步四行或四行以上),37隻眼 (71.2%) 有良好之術後視力(定義為術後最佳矯正視力於Snellen視力表到達20/40或20/40以上)。術前患眼的黃斑部病變之有無,為造成術後視力無法改善之獨立危險因子(勝算比 (odds ratio, OR) 6.84,95%信賴區間(confidence interval, C.I.) 1.12-41.8)、亦為術後視力有無顯著改善之獨立危險因子 (OR 16.1, 95% C.I 2.2-119.9)。此外,糖尿病病史亦考慮為另一造成術後視力不良之獨立危險因子 (OR 15.6, 95% C.I. 0.97-267.6)。有6隻眼 (11.5%) 於術後產生了後發性白內障,需接受銣-雅鉻雷射後囊切開術 (Nd:YAG laser capsulotomy);另有2隻眼 (3.8%)於術後追蹤期中發生了視網膜剝離。 結論:大部分高度近視之白內障患者於白內障術後皆可得到明顯視力改善與良好的術後視力,術前即存在患眼之黃斑部病變為影響術後視力改善程度以及視力本身之危險因子。白內障手術前檢查患眼之視網膜黃斑部,對於避免術後視力不良、術後視力改善有限以及術後產生視網膜剝離,有決定性之影響。 |
英文摘要 | Purpose: The purposes of this study are to describe the visual outcome of highly myopic eyes undergoing cataract surgery and, to investigate associated risk factors for poor postoperative vision, and to assess postoperative complication frequency among the prevalent myopic Taiwanese population. Methods: High myopia was defined as an axial length of ≥26.0 mm. Main study outcomes were visual acuity for the initial 6-month postoperative period (including quality and improvement of postoperative vision), and postoperative complications (including subsequent cataract formation and postoperative retinal detachment). Results: Fifty-two highly myopic eyes were enrolled between January 2002 and December 2004. Mean follow-up interval was 33.3 weeks. Thirty-two eyes (61.5%) had good postoperative visual improvement (≧4 line Snellen chart). Thirty-seven eyes (71.2%) achieved good postoperative vision (20/40 or better). Fifteen eyes (28.8%) demonstrated poor postoperative vision. Pre-existing maculopathy was an independent risk factor for failure to achieve good postoperative vision (odds ratio (OR) 6.84, 95% confidence interval (C.I.): 1.12-41.8) and improvement (OR 16.1, 95% C.I.: 2.2-119.9). Diabetic history was considered another independent risk factor for poor postoperative vision (OR 15.6, 95% C.I.: 0.97-267.6). Six eyes (11.5%) developed subsequent cataract requiring Nd:YAG laser capsulotomy. Two eyes (3.8%) developed retinal detachment during follow-up. Conclusions: Most highly myopic eyes achieved good visual improvement and good postoperative visual acuity after cataract surgery. Pre-existing maculopathy was an independent risk factor of postoperative visual improvement and status. It is crucial to examine retinal status prior to cataract surgery to prevent poor vision improvement, poor postoperative vision, or retinal complications. |
本系統中英文摘要資訊取自各篇刊載內容。