Assessment for Macular Thickness after Uncomplicated Phacoemulsification Using Optical Coherence Tomography
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Macular edema including cystoid macular edema is one of the main causes of unfavorable visual outcomes aftercataract surgery. The macular thickness and the occurrence of macular edema after uncomplicated cataract surgery wasevaluated using optical coherence tomography (OCT) in this study. Methods: Macular map images were taken by OCT before surgery and at 1 week, 1 month, and 2 months postsurgery. Thesubjects were classified into two groups (group 1, patients with no macular edema; group 2, patients with macular edema). Group 2 was defined as increase in central macular thickness (CMT) by 30% compared with that before surgery. The risk factorsfor macular edema were evaluated. Group 2 was divided into two subgroups: subclinical macular edema (group 2A) andcystoid macular edema (group 2B) and they were assessed in terms of the clinical course of best-corrected visual acuity and CMT. Results: A total of 376 patients were enrolled in this study, of which 36 (9.57%, group 2) showed macular edema measuredby OCT after the surgery. Univariate analysis for group 1 and 2 revealed that intracameral injection of epinephrine duringphacoemulsification was associated with the development of macular edema. In group 2, five patients (1.33%) developedcystoid macular edema. Statistically significant differences in the clinical course of CMT were observed at 2 months (201.2± 23.1, 250.0 ± 29.8, and 371.0 ± 160.3 in group 1, group 2A, and group 2B, respectively; p < 0.001) and 1 month postoperatively(198.5 ± 23.6, 237.8 ± 40.9, and 314.0 ± 104.5 in group 1, group 2A, and group 2B, respectively; p < 0.001). Group 2Brequired additional treatment and eventually achieved best-corrected visual acuity of >0.2 with CMT in the normal range. Conclusions: The intracameral injection of epinephrine may cause macular edema after uncomplicated cataract surgery. Examination of CMT using OCT is recommended for the early detection of macular edema.
Abstract
Purpose: Macular edema including cystoid macular edema is one of the main causes of unfavorable visual outcomes aftercataract surgery. The macular thickness and the occurrence of macular edema after uncomplicated cataract surgery wasevaluated using optical coherence tomography (OCT) in this study. Methods: Macular map images were taken by OCT before surgery and at 1 week, 1 month, and 2 months postsurgery. Thesubjects were classified into two groups (group 1, patients with no macular edema; group 2, patients with macular edema). Group 2 was defined as increase in central macular thickness (CMT) by 30% compared with that before surgery. The risk factorsfor macular edema were evaluated. Group 2 was divided into two subgroups: subclinical macular edema (group 2A) andcystoid macular edema (group 2B) and they were assessed in terms of the clinical course of best-corrected visual acuity and CMT. Results: A total of 376 patients were enrolled in this study, of which 36 (9.57%, group 2) showed macular edema measuredby OCT after the surgery. Univariate analysis for group 1 and 2 revealed that intracameral injection of epinephrine duringphacoemulsification was associated with the development of macular edema. In group 2, five patients (1.33%) developedcystoid macular edema. Statistically significant differences in the clinical course of CMT were observed at 2 months (201.2± 23.1, 250.0 ± 29.8, and 371.0 ± 160.3 in group 1, group 2A, and group 2B, respectively; p < 0.001) and 1 month postoperatively(198.5 ± 23.6, 237.8 ± 40.9, and 314.0 ± 104.5 in group 1, group 2A, and group 2B, respectively; p < 0.001). Group 2Brequired additional treatment and eventually achieved best-corrected visual acuity of >0.2 with CMT in the normal range. Conclusions: The intracameral injection of epinephrine may cause macular edema after uncomplicated cataract surgery. Examination of CMT using OCT is recommended for the early detection of macular edema.
참고문헌 (26)
- "Cystoid macular edema in aphakic and pseudophakic eyes", Am J Ophthalmol, 88, pp.45~48 (1979)
- Stark WJ, "The FDA report on intraocular lenses", Ophthalmology, 90, pp.311~317 (1983)
- Rossetti L, "Cystoid macular edema following cataract surgery", Curr Opin Ophthalmol, 11, pp.65~72 (2000)
- Norregaard JC, "Intraoperative clinical practice and risk of early complications after cataract extraction in the United States, Canada, Denmark, and Spain", Ophthalmology, 106, pp.42~48 (1999)
- Rossetti L, "Medical prophylaxis and treatment of cystoid macular edema after cataract surgery. The results of a meta-analysis", Ophthalmology, 105, pp.397~405 (1998)
- Ray S, "Pseudophakic cystoid macular edema", Semin Ophthalmol, 17, pp.167~180 (2002)
- Ruiz RS, "Visual outcome in pseudophakic eyes with clinical cystoid macular edema", Ophthalmic Surg, 22, pp.190~193 (1991)
- Hayashi K, "Changes in diabetic macular oedema after phacoemulsification surgery", Eye(Lond), 23, pp.389~396 (2009)
- Kim SJ, "Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography", Ophthalmology, 114, pp.881~889 (2007)
- Flesner P, "Cataract surgery on diabetic patients. A prospective evaluation of risk factors and complications", Acta Ophthalmol Scand, 80, pp.19~24 (2002)
- Nelson ML, "Managing cystoid macular edema after cataract surgery", Curr Opin Ophthalmol, 14, pp.39~43 (2003)
- 안태수, "당뇨환자의 백내장 수술 후 중심황반두께의 변화", 대한안과학회지, 53(10), pp.1472~1479 (2012), 대한안과학회[DOI]
- 김준용, "빛간섭단층촬영을 이용한 당뇨환자의 백내장 수술 후 황반부종의 분석", 대한안과학회지, 51(3), pp.340~346 (2010), 대한안과학회
- Lobo C, "Pseudophakic cystoid macular edema", Ophthalmologica, 227, pp.61~67 (2012)
- Chylack LT Jr, "The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group", Arch Ophthalmol, 111, pp.831~836 (1993)
- Hee MR, "Quantitative assessment of macular edema with optical coherence tomography", Arch Ophthalmol, 113, pp.1019~1029 (1995)
- Goebel W, "Retinal thickness in diabetic retinopathy : a study using optical coherence tomography(OCT)", Retina, 22, pp.759~767 (2002)
- Mentes J, "Incidence of cystoid macular edema after uncomplicated phacoemulsification", Ophthalmologica, 217, pp.408~412 (2003)
- Loewenstein A, "Postsurgical cystoid macular edema", Dev Ophthalmol, 47, pp.148~159 (2010)
- Yoshida A, "Inward and outward permeability of the blood-retinal barrier in experimental myopia", Graefes Arch Clin Exp Ophthalmol, 234(Suppl 1), pp.S239~S242 (1996)
- Giansanti F, "Evaluation of macular thickness after uncomplicated cataract surgery using optical coherence tomography", Eur J Ophthalmol, 23, pp.751~756 (2013)
- Mackool RJ, "Epinephrine-induced cystoid macular edema in aphakic eyes", Arch Ophthalmol, 95, pp.791~793 (1977)
- Bozkurt E, "Effect of intracameral epinephrine use on macular thickness after uneventful phacoemulsification", J Cataract Refract Surg, 36, pp.1380~1384 (2010)
- Myers WG, "Shortage of bisulfite-free preservative-free epinephrine for intracameral use", J Cataract Refract Surg, 37, pp.611~ (2011)
- Robinson F, "The acute effect of topical epinephrine on macular blood flow in humans", Invest Ophthalmol Vis Sci, 33, pp.18~22 (1992)
- Meng Z, "The vasorelaxant effect and its mechanisms of sodium bisulfite as a sulfur dioxide donor", Chemosphere, 89, pp.579~584 (2012)