论文部分内容阅读
目的:探讨高度近视者白内障术前全视网膜镜检查的意义。方法:回顾性分析2019年10月至2020年9月郑州大学第一附属医院216名(295只眼)高度近视者白内障手术的临床资料。按术前是否行全视网膜镜检查将患者分为4组：A组，171只眼，未行全视网膜镜检查；B组，64只眼，行全视网膜镜检查眼底但无需进行眼底病的治疗；C组，39只眼，行全视网膜镜检查，并行视网膜光凝治疗；D组，21只眼，经B型超声及OCT检查未发现视网膜病变区，而全视网膜镜检查示周边部视网膜脱离，并行相应手术治疗。术后1周、1个月及3个月随访，对比分析A、B、C三组间术前与术后视力、眼压及发生高度近视性视网膜病变情况的差异，以及全视网膜镜检查效果。结果:各组间基线资料差异无统计学意义。术后3个月A、B、C组患者视力均较术前提高(n P<0.05)。B组患者手术前后视力变化量优于A组(n P<0.05)。术后1个月A组出现视网膜变性19只眼、视网膜裂孔17只眼，均高于其余3组(n P<0.05)。行术前全视网膜镜检查者共124只眼，包括周边部视网膜脱离者21只眼、视网膜变性者26只眼、视网膜裂孔者17只眼、脉络膜视网膜萎缩者14只眼、黄斑病变者3只眼、无明显眼底病变者43只眼。n 结论:全视网膜镜检查对高度近视者的视网膜病变有较好的检出效果。高度近视者白内障术前全视网膜镜检查并及时采取视网膜光凝治疗，能使术后获得较好视力且可减少术后高度近视性视网膜病变的发生。“,”Objective:To investigate the significance of preoperative panretinoscopy for cataract in high myopes.Methods:The clinical data of 295 eyes of 216 high myopes of cataract surgeries from Oct. 2019 to Sep. 2020 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The patients were divided into 4 groups based on whether they received panretinocopy before surgery. Inthe group A, 171 eyes had no panretinoscopy. In the group B, 64 eyes underwent panretinoscopy without the treatment of fundus disease. In the group C, 39 eyes received panretinoscopy and retinal photocoagulation therapy. In the group D, 21 eyes were treated with corresponding surgery after B ultrasound and OCT examination without retinopathy, while peripheral retinal detachment was found with panretinoscopy. The patients were followed up for 1 week, 1 month and 3 months after surgery. The preoperative and postoperative visual acuity, intraocular pressure, and the occurrence of high myopic retinopathy were compared and analyzed among group A, group B and group C after surgery, as well as the detective efficacy of panretinoscopy.Results:There was no significant difference in baseline data among the four groups.The visual acuity of group A, group B and group C at 3 months after surgery was higher than that before surgery (n P<0.05). The difference of visual acuity change in the group B was better than that in the group A before and after operation (n P<0.05). At 1 month after operation, 19 eyes in the group A had retinal degeneration and 17 eyes with retinal tear, which were much higher than those of the other 3 groups (n P<0.05). Preoperative panretinoscopy was performed in 124 eyes, including peripheral retinal detachment in 21 eyes, retinal degeneration in 26 eyes, retinal tear in 17 eyes, choroidal retinal atrophy in 14 eyes, macular degeneration in 3 eyes, and no obvious fundus lesions in 43 eyes.n Conclusion:The panretinoscopy was effective in detecting retinopathy in high myopes. Preoperative panretinoscopy and prompt retinal photocoagulation therapy in high myopic patients with cataract can improve postoperative vision and reduce the incidence of high myopic retinopathy.