Artzén Ditte, Lundström Mats, Behndig Anders, Stenevi Ulf, Lydahl Eva, Montan Per
St. Erik Eye Hospital, Stockholm.
J Cataract Refract Surg. 2009 Oct;35(10):1688-93. doi: 10.1016/j.jcrs.2009.05.026.
To identify preoperative and intraoperative factors associated with a capsule complication; that is, a capsule tear or a zonular dehiscence during cataract surgery.
Ten ophthalmic surgery departments in Sweden.
A retrospective review of files of patients with a capsule complication and control patients with no complication operated on in 2003 was performed.
The review comprised 324 patients with a capsule complication and 331 control patients. In the logistic regression analyses, preoperative conditions associated with a capsule complication were previous trauma, white and brunescent/hard cataract, and phacodonesis. The intraoperative factors of loose zonules, the use of trypan blue, and miosis were all statistically significantly overrepresented in the capsule complication group. The same was true for eyes operated on by surgeons with the least experience.
By preoperatively identifying cataract cases with the identified risk factors and allocating them to surgeons with the longest experience, the number of capsule complications could be kept low. Operating early in the course of the disease to prevent the cataract from becoming a poor surgical risk and improving training of junior surgeons should further reduce the frequency of capsule complications.
确定与囊膜并发症相关的术前和术中因素，即白内障手术期间的囊膜撕裂或悬韧带断裂。
瑞典的十个眼科手术科室。
对2003年接受手术的有囊膜并发症的患者和无并发症的对照患者的病历进行回顾性研究。
该回顾包括324例有囊膜并发症的患者和331例对照患者。在逻辑回归分析中，与囊膜并发症相关的术前情况包括既往外伤、白色及棕色/硬性白内障和晶状体震颤。囊膜并发症组中，悬韧带松弛、使用台盼蓝和瞳孔缩小等术中因素在统计学上均显著高于对照组。经验最少的外科医生所手术的眼睛也是如此。
通过术前识别具有已确定危险因素的白内障病例并将其分配给经验最丰富的外科医生，可以使囊膜并发症的数量保持在较低水平。在疾病过程早期进行手术以防止白内障成为手术风险较高的病例，并改善初级外科医生的培训，应能进一步降低囊膜并发症的发生率。
