摘要
目的初步探讨维持性血液透析的老年白内障患者围术期视力、眼压、角膜参数、前房深度及眼轴等眼部参数的变化。方法收集2019年1月—2020年12月在上海市静安区闸北中心医院眼科行白内障超声乳化吸出联合IOL植入术的连续病例。其中诊断为肾功能衰竭并且行维持性血液透析治疗(HD)的患者作为肾病组纳入本次研究。对肾病组患者白内障术前HD前1 h,HD后1 h及HD间歇期的眼压、角膜参数、前房深度及眼轴变化进行对比,同时和对照组患者围术期的视力、眼压及角膜参数、前房深度、眼轴等数据进行比较。结果患者在HD的不同时间段,眼压出现波动。术前肾病组角膜厚度与对照组差异无统计学意义,但肾病组在术后第1天角膜厚度明显大于对照组,术后1个月这种差异性消失。肾病组血透后1 h前房深度较血透前1 h及血透间歇明显变小,白内障术后1个月肾病组前房深度较术前明显加深。肾病组术后第1天及术后1个月视力恢复要差与对照组。术后1个月HD不同时间段测量所得的平均绝对屈光度误差差异有统计学意义(F=6.572,P=0.002),与对照组差异也有统计学意义(t=3.771,P=0.001)。结论肾病组患者进行HD的不同时间段,患者眼压和前房深度会出现波动,选择合适的白内障术前检查时间,晶体预测度数会更加准确。肾病组患者较普通白内障患者,手术后第1天可能更易出现角膜水肿反应及眼压升高表现,肾病组患者白内障手术预后要差于普通白内障患者。
Objective To investigate the changes of ocular parameters(visual acuity,intraocular pressure,corneal parameters,anterior chamber depth and ocular axis)during perioperative period in elderly cataract patients undergoing hemodialysis(HD).Methods Continuous patients who underwent phacoemulsification combined with IOL implantation in Department of Ophthalmology,Zhabei Central Hospital,Jing an District from January 2019 to December 2020 were collected.Among them,patients diagnosed with renal failure and undergoing HD were included in the nephropathy group.The changes of intraocular pressure,corneal parameters,anterior chamber depth and axial length 1 h before HD,1 h after HD and at HD interval of the nephropathy group were compared.At the same time,the above indexes were compared with those of the control group.Results During different periods of HD,patients intraocular pressure fluctuated.There was no significant difference in preoperative corneal thickness between the nephropathy group and the control group,but the corneal thickness of the nephropathy group was significantly greater than that of the control group on the first day after surgery,and this difference disappeared one month after surgery.The depth of anterior chamber of the nephropathy group 1 h after HD was significantly smaller than that 1 h before HD and at HD interval.One month after the cataract operation,the depth of the anterior chamber of the nephropathy group was significantly greater than that before surgery.The visual acuity recovery of the nephropathy group was worse than that of the control group on the first day and one month after surgery.One month after the operation,the mean absolute diopter errors measured at different periods of HD showed a statistically significant difference(F=6.572,P=0.002),and there was also a statistically significant difference compared to the control group(t=3.771,P=0.001).Conclusion The intraocular pressure and anterior chamber depth of HD patients would fluctuate in different periods of HD.Therefore,the predict
作者
丁蕙
江利红
姚怡芸
王玮
顾晓莹
Ding Hui;Jiang Lihong;Yao Yiyun;Wang Wei;Gu Xiaoying(Department of Ophthalmology,Zhabei Central Hospital,Jing an District,Shanghai,200070,P.R.China)
出处
《老年医学与保健》
CAS
2024年第4期1099-1105,共7页
Geriatrics & Health Care
基金
上海市静安区医学科研课题(面上2023MS07)。
关键词
老年
维持性血液透析
白内障
超声乳化
elderly
maintained hemodialysis
cataract
phacoemulsification
