Küchle M, Viestenz A, Martus P, Händel A, Jünemann A, Naumann G O
Department of Ophthalmology and University Eye Hospital, Erlangen, Germany.
Am J Ophthalmol. 2000 Mar;129(3):281-5. doi: 10.1016/s0002-9394(99)00365-7.
To look for associations of preoperative A-scan ultrasound ocular dimensions with complications during phacoemulsification in eyes with pseudoexfoliation.
A total of 174 eyes with pseudoexfoliation of 135 patients undergoing planned cataract surgery were included in a prognostic study based on the review of a clinical database. Preoperatively, A-scan ultrasound examination with measurement of anterior chamber depth, lens thickness, and total axial length was performed. Phacoemulsification with implantation of a posterior chamber intraocular lens was performed by a total of five surgeons. Intraoperative complications (zonular dialysis and/or vitreous loss) were correlated with preoperative findings including ultrasound dimensions. Multivariate logistic regression analysis with a generalized estimating equations method was used for statistical analysis.
Intraoperative complications occurred in 12 eyes (6.9%) of 11 patients. The anterior chamber was significantly shallower in eyes with than in eyes without complications (mean, 2.36 +/- 0.44 mm vs 2.74 +/- 0.52 mm; P =.013). The differences in lens thickness (4.93 +/- 0.55 mm vs 4.72 +/- 0.54 mm; P =.30) and the differences in axial length (22.92 +/- 1.09 mm vs 23.66 +/- 1.36 mm; P =.07) between the two groups did not reach statistical significance. In eyes with pseudoexfoliation, an anterior chamber depth of less than 2.5 mm was associated with a risk of 13.4% for intraoperative complications compared with an overall incidence of intraoperative complications of 6.9% and an incidence of 2.8% for an anterior chamber depth of 2.5 mm or more.
A small anterior chamber depth may indicate zonular instability in eyes with pseudoexfoliation syndrome and should alert the cataract surgeon to the possibility of intraoperative complications.
探寻假性剥脱性眼病患者在超声乳化白内障吸除术中术前A超测量的眼轴参数与并发症之间的关联。
基于临床数据库回顾，对135例计划行白内障手术的假性剥脱性眼病患者的174只眼进行预后研究。术前进行A超检查，测量前房深度、晶状体厚度和眼轴总长度。共有5位外科医生实施了超声乳化白内障吸除联合后房型人工晶状体植入术。术中并发症（悬韧带断裂和/或玻璃体脱出）与术前检查结果（包括超声测量参数）进行相关性分析。采用广义估计方程法进行多因素逻辑回归分析以进行统计学分析。
11例患者的12只眼（6.9%）发生术中并发症。发生并发症的患眼前房明显比未发生并发症的患眼前房浅（平均分别为2.36±0.44mm和2.74±0.52mm；P = 0.013）。两组间晶状体厚度差异（4.93±0.55mm比4.72±0.54mm；P = 0.30）和眼轴长度差异（22.92±1.09mm比23.66±1.36mm；P = 0.07）未达到统计学意义。在假性剥脱性眼病患者中，前房深度小于2.5mm的患者术中并发症风险为13.4%，而术中并发症总体发生率为6.9%，前房深度2.5mm及以上的患者术中并发症发生率为2.8%。
前房深度较小可能提示假性剥脱综合征患者悬韧带不稳定，白内障手术医生应警惕术中并发症的可能性。
