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[白内障手术中的假性剥脱综合征。37例回顾性研究]

[Pseudoexfoliation syndrome in cataract surgery. Retrospective study of 37 cases].

作者信息

Streho M, Rohart C, Guigui B, Fajnkuchen F, Chaine G

机构信息

Service d'Ophtalmologie, Hôpital Avicenne, Assistance publique hôpitaux de Paris, Faculté de médecine de Paris XIII, Bobigny.

出版信息

J Fr Ophtalmol. 2008 Jan;31(1):11-5. doi: 10.1016/s0181-5512(08)70324-3.

Abstract

PURPOSE

To analyze the clinical features of pseudoexfoliation syndrome and to determine complications in cataract surgery in eyes with pseudoexfoliation syndrome compared with eyes without this syndrome.

METHODS

A retrospective, single-center comparative study was conducted on patients who underwent cataract surgery between 2004 and 2006. Demographic parameters (age, sex, ethnicity, medical and ophthalmologic history), clinical features (visual acuity, pupil dilatation, intraocular pressure) before and after surgery, and surgical complications were analyzed and compared to a control group without pseudoexfoliation.

RESULTS

Seventy-four eyes of 71 patients were included in the study. The sex ratio of the pseudoexfoliation group was 1.26 with 19 males (56%) and 15 females (44%). Pseudoexfoliation was unilateral in 21 cases (61%). Open-angle glaucoma was associated in 11 cases (32%) in the pseudoexfoliation group versus two cases in the control group (5.4%). Poor pupil dilatation was observed in eight cases (24%) in the pseudoexfoliation group and in one case (2.7%) in the control group. Phacoemulsification with IOL was the surgical technique in all the cases with only one case (2.7%) of anterior chamber IOL in the pseudoexfoliation group. There was no significant difference in the surgical complications between the pseudoexfoliation and control group (5.4%). The mean preoperative intraocular pressure was 16+/-5 mmHg in the pseudoexfoliation group and 14+/-3 mmHg in the control group. The mean postoperative intraocular pressure at 1 month was 14+/-4 mmHg in the pseudoexfoliation group and 14+/-3 in the control group. The mean preoperative visual acuity was 1.0+/-0.7 LogMar in the pseudoexfoliation group and 0.7+/-0.5 LogMar in the control group. The mean postoperative visual acuity was 0.4+/-0.6 LogMar in the pseudoexfoliation group and 0.2+/-0.1 LogMar in the control group. The mean follow-up was 70 days in the pseudoexfoliation group and 30 days in the control group.

CONCLUSION

Pseudoexfoliation syndrome is the most common in its unilateral presentation. It is frequently associated with chronic secondary open-angle glaucoma. Poor pupil dilatation is one of the most common problems faced by cataract surgeons. Nevertheless, pseudoexfoliation syndrome did not confer a statistically higher risk for surgical complication in eyes without marked phacodonesis or lens subluxation.

摘要

目的

分析假性剥脱综合征的临床特征,并确定与无该综合征的眼睛相比,患有假性剥脱综合征的眼睛在白内障手术中的并发症。

方法

对2004年至2006年间接受白内障手术的患者进行了一项回顾性、单中心比较研究。分析了人口统计学参数(年龄、性别、种族、医学和眼科病史)、手术前后的临床特征(视力、瞳孔散大、眼压)以及手术并发症,并与无假性剥脱的对照组进行比较。

结果

71例患者的74只眼睛纳入研究。假性剥脱组的性别比为1.26,男性19例(56%),女性15例(44%)。假性剥脱为单侧的有21例(61%)。假性剥脱组11例(32%)合并开角型青光眼,而对照组为2例(5.4%)。假性剥脱组8例(24%)观察到瞳孔散大不良,对照组1例(2.7%)。所有病例均采用超声乳化联合人工晶状体植入术,假性剥脱组仅1例(2.7%)发生前房型人工晶状体。假性剥脱组与对照组的手术并发症无显著差异(5.4%)。假性剥脱组术前平均眼压为16±5 mmHg,对照组为14±3 mmHg。假性剥脱组术后1个月平均眼压为14±4 mmHg,对照组为14±3 mmHg。假性剥脱组术前平均视力为1.0±0.7 LogMar,对照组为0.7±0.5 LogMar。假性剥脱组术后平均视力为0.4±0.6 LogMar,对照组为0.2±0.1 LogMar。假性剥脱组平均随访70天,对照组平均随访30天。

结论

假性剥脱综合征最常见的表现为单侧。它常与慢性继发性开角型青光眼相关。瞳孔散大不良是白内障手术医生面临的最常见问题之一。然而,在没有明显晶状体震颤或晶状体半脱位的眼睛中,假性剥脱综合征并未在统计学上增加手术并发症的风险。

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