不快乐的20/20:白内障手术的新挑战
Chiara De Gregorio1,2, Sebastiano Nunziata1,2, Sara Spelta1,2
1Ophthalmology Complex Operative Unit, Ophthalmology Campus Bio-Medico University, 00128 Rome, Italy.
Journal of clinical medicine
|March 17, 2025
概括
白内障手术可能导致近一半患者的眼表系统衰竭 (OSSF) 和干眼疾病 (DED) 症状,影响满意度. 周期性管理是改善结果的关键.
科学领域:
- 眼科医生 眼科 眼科
- 眼睛表面疾病 眼睛表面疾病
- 白内障手术的结果
背景情况:
- 现代白内障手术旨在实现折射结果,增加对高级眼内透镜 (IOL) 的需求.
- 眼表面功能障碍 (OSD),包括干眼疾病 (DED),在白内障手术后显著影响患者的满意度,即使视力敏度很好.
- 高达35%的患者报告由于OSD的不满,尽管实现了20/20视力.
研究的目的:
- 在白内障手术后进行术后眼睛表面系统衰竭 (OSSF) 的特征.
- 探索改善白内障患者OSD周术管理的策略.
主要方法:
- 一项开放的观察性研究包括20名透镜不透明的患者 (N2-3,C1-2阶段).
- 排除了糖尿病患者,以前的眼部手术或炎症性眼病的患者.
- 评估OSD使用OSDI,SANDE得分,希尔默测试,撕裂时间 (TBUT) 和光素染色术前和术后1周,1个月,3个月.
主要成果:
- 尽管达到20/20最佳校正视敏度 (BCVA),但44%的患者出现了OSSF症状.
- 在术后观察到OSDI和SANDE得分的显著恶化,Schirmer测试结果减少,TBUT减少 (p < 0.001).
- 梅博米腺功能障碍和结膜高血症也显示了术后的恶化.
结论:
- 手术后的OSSF源于神经性炎症,膜不稳定性和梅博米腺功能障碍,由手术创伤加重.
- 术前和术后的管理,包括人工眼,盖卫生和无防腐剂的解决方案至关重要.
- 综合性策略可以减轻OSSF症状,提高患者的满意度,并最大限度地提高白内障手术的好处.
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