Chan Jonathan C H, Lai Jimmy S M, Tham Clement C Y
Department of Ophthalmology, United Christian Hospital, Hong Kong SAR, China.
J Glaucoma. 2006 Feb;15(1):26-9. doi: 10.1097/01.ijg.0000196620.41991.b6.
To compare the postoperative refractive outcomes following phacotrabeculectomy and phacoemulsification with posterior chamber intraocular lens implantation.
A retrospective comparative study of 90 consecutive patients (95 eyes) with cataract with or without co-existing glaucoma who had undergone uncomplicated phacotrabeculectomy or phacoemulsification by a single surgeon. The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refractive outcome, in spherical equivalent. This was followed by a comparative analysis of the mean biometry prediction error, and the number of cases with error >0.50 D or 1.00 D. All biometry measurements were performed by one of the two qualified optometrists.
The mean and absolute mean biometry prediction error of the 25 eyes that received phacotrabeculectomy (+0.20 D, absolute error 0.96 D) was comparable to the 70 eyes that received phacoemulsification (-0.14 D, absolute error 0.68 D), P = 0.18 (absolute error, P = 0.12). The proportion of cases with prediction error >0.50 D or 1.00 D was 60% or 40% for phacotrabeculectomy, and 44% or 17% for phacoemulsification, respectively. Phacotrabeculectomy was more likely to have a prediction error >1.00 D (P = 0.02) and a myopic shift of >0.50 D or 1.00 D (P = 0.03 or 0.02, respectively). No significant differences were found with regard to the frequency of hyperopic shift or prediction error >0.50 D. There was no significant difference in either the mean error or the frequency of the different types of error for the different biometry operators, types of glaucoma, or postoperative intraocular pressure control success status.
Myopically shifted prediction error was significantly more frequent following posterior chamber intraocular lens implantation with phacotrabeculectomy compared with phacoemulsification, even when surgery was uncomplicated and performed by the same surgeon.
比较超声乳化小梁切除术与白内障超声乳化吸除联合后房型人工晶状体植入术后的屈光效果。
对90例（95只眼）患有或不伴有青光眼的白内障患者进行回顾性比较研究，这些患者均由同一位外科医生进行了单纯的超声乳化小梁切除术或白内障超声乳化吸除术。通过实际术后屈光与术前预测屈光结果（球镜等效度）之间的差异，确定每例患者的生物测量预测误差。随后对平均生物测量预测误差以及误差>0.50 D或1.00 D的病例数进行比较分析。所有生物测量均由两名合格验光师中的一人进行。
接受超声乳化小梁切除术的25只眼的平均及绝对平均生物测量预测误差（+0.20 D，绝对误差0.96 D）与接受白内障超声乳化吸除术的70只眼（-0.14 D，绝对误差0.68 D）相当，P = 0.18（绝对误差，P = 0.12）。超声乳化小梁切除术预测误差>0.50 D或1.00 D的病例比例分别为60%或40%，白内障超声乳化吸除术分别为44%或17%。超声乳化小梁切除术更易出现预测误差>1.00 D（P = 0.02）以及近视偏移>0.50 D或1.00 D（分别为P = 0.03或0.02）。在远视偏移频率或预测误差>0.50 D方面未发现显著差异。对于不同的生物测量操作人员、青光眼类型或术后眼压控制成功状态，平均误差或不同类型误差的频率均无显著差异。
与白内障超声乳化吸除术相比，超声乳化小梁切除联合后房型人工晶状体植入术后近视性偏移预测误差明显更常见，即使手术过程顺利且由同一位外科医生实施。
