| Objective:Diagnosing macular degeneration in patients with Age-related cataract beforecataract surgery by Optical coherence tomography. Dynamic monitoring the macularstructure before and after cataract phacoemulsification and artificial intraocular lensimplantation.Method:288patients(386eyes)with cataract were enrolled in this study who had undergonecataract phacoemulsification and artificial intraocular lens implantation between June2011and August2012. The ocular fundus of all selected patients were checkedrespectively by fundus pre-set lens and OCT to screen macular degeneration. In the end,we compared the effectiveness of these two methods and analysed different kinds ofmacular degeneration and probable influencing factors.171patients (222eyes) wereenrolled according to the standard and detailed ophthalmologic examinations and OCTmeasurements were proceeded at five time point: pre-operation, postoperative1st day,postoperative3rd day, postoperative1st week and postoperative1st month. They weredivided into two groups as following: Group A,106patients (149eyes) who had not beenfound any macular degeneration by OCT before surgery, and Group B,65patients (73eyes) who had been found macular degeneration by OCT before surgery. Best correctedvisual acuity (BCVA) was measured as logMAR units at preoperative and allpostoperative visits. Central macular thicknesses of patients from these two groups beforeand afrer operation were respectively compared to analyse the correlation between visionand central macular thickness.Results:Ocular fondues of all preoperative patients with cataract were cheeked respectivelyby OCT and fundus pre-set lens. The detection rate of macular degeneration by the formermethod was23.8%, and the latter one was15.3%. In addition, the differences betweenthese two methods reached the P value (P<0.05). By Analysing their medical records, wefound that the aged patients or patients combined with diabetes, pathological myopia, oruveitis were more likely to have the macular degeneration. The differences between thesetwo groups were statistically significant (P<0.05), while no sex difference seemed to befound between them (P>0.05). Different kinds of macular degenerations of all cataract patients were detected by OCT preoperative, and ranked by the rates: macularedema(19.5%), drusen(13.04%), pathologic myopia choroidal atrophy(10.87%), atrophicage-related macular degeneration(10.87%), macular membrane(8.70%), hardexudates(8.70%), atrophic discoid eicatrization (6.52%), cytoid bodies(5.43%), choroidalneovascularization(4.35%), pathologic myopia retinal detachment/splitting andhole(4.35%), macula hole(2.17%), subretinal hemorrhage(2.17%) and vitreomaculartraction syndrome(1.09%).The central macular thickness of group A before operation and at postoperative1stday,3rd day,1st week,1st month were: respectively,248.23±20.49μm，254.64±19.60μm，253.42±17.90μm，252.14±18.88μm，255.19±20.54μm. A paired t-testwas performed to analyze the data and examine changes of central macular thickness ineach of the five periods. The postoperative data were increased significantly compared tothe preoperative results(P<0.05), while no significant differences seemed to be foundbetween postoperative time points（P>0.05）,it was considered because that the opacity inthe lens may affect the former results. The average macular thickness in the central foveashowed no correlation with visual acuity at all stages of postoperation.The central macular thickness of group B before operation and at postoperative1stday,3rd day,1st week,1st month were analyzed by a paired t-test, which showedsignificant difference in central macular thickness before operation and those at differenttime points after operation (P＜0.05). By separately comparing each kind of maculardegenerations, we found significant difference between central macular thickness atpostoperative1st month and the other different time points after operation in patients withmacular edema before surgery(P＜0.05). The average macular thickness in the centralfovea showed a negative correlation with visual acuity at all stages of postoperation,which means that the thicker of the macular retinal, the worse of the visual acuity.However, the rest kinds of macular degeneration had no significantly difference betweenpostoperative datas（P＞0.05）, and the average macular thickness in the central foveashowed no correlation with visual acuity at all stages of postoperation.Conclusion:OCT is highly sensible in suspection of maculopathy before cataract surgery. It willhave important directive significance to roughly evaluate of postoperative visual acuity,choose of the intraocular lens and treat for macular degeneration; Macular thickness willnot magnificently change after uncomplicated phacoemulsification surgery at patientswith simply cataract in a short term. |
PDF Full Text Request