Cheng L, Azen S P, El-Bradey M H, Scholz B M, Chaidhawangul S, Toyoguchi M, Freeman W R
Department of Ophthalmology, Shiley Eye Center, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA 92093-0946, USA.
Am J Ophthalmol. 2001 Dec;132(6):881-7. doi: 10.1016/s0002-9394(01)01263-6.
To report the association between duration of vitrectomy, as well as other risk factors, and the progression of nuclear sclerosis and posterior subcapsular cataract in the Vitrectomy for Macular Hole Study.
A cohort study nested within a randomized controlled clinical trial.
Using a system similar to the Lens Opacities Classification System II, nuclear sclerosis (NS) and posterior subcapsular cataract (PSC) were scored in the vitrectomy and fellow eye of 74 patients at baseline and at 6, 12, and 24 months postoperatively. Age, baseline blood pressure and refractive power, and duration of surgery were evaluated as risk factors for NS or PSC progression and cataract extraction.
The incidence of NS progression in the surgical group of vitrectomy eyes was 81% at 6 months, 98% at 1 year, and 100% at 2 years of follow-up. In contrast, NS progression in the control group of fellow eyes was only 18% at 6 months, 20% at 1 year, and 8% at 2 years. The incidence of PSC progression in the surgical group remained at approximately 11% throughout follow-up, which was not significantly higher than the 3% to 5% incidence in the control group. Vitrectomy was significantly related to progression of NS cataract (P <.001) and cataract extraction (P <.01). No statistically significant differences were found for NS scores, PSC scores, or progression rates between eyes that had less than median surgical duration (60 min.) or more than the median surgical duration. Additionally, no significant differences were found when eyes that experienced 45 minutes or less surgical duration were compared with eyes that endured more than 75 minutes surgical duration. Age, blood pressure, and refractive power were not found to be predictors for NS and PSC progression.
Although vitrectomy is a risk factor for NS progression, the duration of vitrectomy does not increase the risk.
在黄斑裂孔玻璃体切除术研究中，报告玻璃体切除术的持续时间以及其他风险因素与核性硬化和后囊下白内障进展之间的关联。
一项嵌套于随机对照临床试验的队列研究。
使用类似于晶状体混浊分类系统II的系统，在74例患者的玻璃体切除眼及其对侧眼中，于基线时以及术后6、12和24个月对核性硬化（NS）和后囊下白内障（PSC）进行评分。将年龄、基线血压和屈光力以及手术持续时间评估为NS或PSC进展及白内障摘除的风险因素。
在玻璃体切除眼的手术组中，随访6个月时NS进展的发生率为81%，1年时为98%，2年时为100%。相比之下，对侧眼对照组中NS进展在6个月时仅为18%，1年时为20%，2年时为8%。手术组中PSC进展的发生率在整个随访期间保持在约11%，并不显著高于对照组中3%至5%的发生率。玻璃体切除术与NS白内障进展（P <.001）和白内障摘除（P <.01）显著相关。手术持续时间少于中位数（60分钟）或多于中位数的眼之间，在NS评分、PSC评分或进展率方面未发现统计学上的显著差异。此外，并将手术持续时间为45分钟或更短的眼与手术持续时间超过75分钟的眼进行比较时，也未发现显著差异。未发现年龄、血压和屈光力是NS和PSC进展的预测因素。
尽管玻璃体切除术是NS进展的一个风险因素，但玻璃体切除术的持续时间并不会增加该风险。
