Jakobsson Gunnar, Montan Per, Zetterberg Madeleine, Stenevi Ulf, Behndig Anders, Lundström Mats
Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal.
J Cataract Refract Surg. 2009 Oct;35(10):1699-705. doi: 10.1016/j.jcrs.2009.05.028.
To study the incidence, characteristics, and results of retinal detachment (RD) after cataract surgery with a capsule complication.
Ten ophthalmic surgery departments in Sweden.
In this case-control study, data on cataract surgery cases with a capsule complication (study group) or with no complication (control group) in 2003 were extracted from the Swedish National Cataract Register. Patients with RD during a 3-year follow-up were identified.
The study group comprised 324 patients and the control group, 331 patients. Retinal detachment occurred in 13 study group patients, for a 3-year incidence of 4.0%. In the control group, 1 patient (0.3%) had RD. Multivariate analysis showed an adjusted odds ratio (OR) of 14.8 for RD after capsule complication (95% confidence interval [CI], 1.9-114; P = .01). Subgroup analysis of the study group using a binary logistic regression model showed that male sex (OR, 8.5; 95% CI, 1.7-43.8; P = .001) and lens remnants in the vitreous (OR, 14.4; 95% CI 2.6-78.8; P = .002) were additional risk factors. Axial myopia was significantly associated with an increased risk as a single factor but not as a multiple factor. In general, the final visual outcome for RD after a capsule complication was poor; 3 eyes had a visual acuity of 0.50 or better. Eight eyes (62%) had a final visual acuity worse than 0.10 and 6 eyes, 0.02 or worse.
The risk for RD after cataract surgery increased significantly when a capsule complication occurred, leading to poor final visual acuity in most cases.
研究白内障手术并发晶状体囊膜并发症后视网膜脱离(RD)的发生率、特征及预后。
瑞典的十个眼科手术科室。
在这项病例对照研究中,从瑞典国家白内障登记处提取了2003年有晶状体囊膜并发症的白内障手术病例(研究组)或无并发症的病例(对照组)的数据。确定在3年随访期间发生RD的患者。
研究组包括324例患者,对照组包括331例患者。研究组有13例患者发生视网膜脱离,3年发生率为4.0%。对照组有1例患者(0.3%)发生视网膜脱离。多因素分析显示,晶状体囊膜并发症后发生视网膜脱离的校正优势比(OR)为14.8(95%置信区间[CI],1.9 - 114;P = 0.01)。使用二元逻辑回归模型对研究组进行亚组分析显示,男性(OR,8.5;95% CI,1.7 - 43.8;P = 0.001)和玻璃体中的晶状体残留(OR,14.4;95% CI 2.6 - 78.8;P = 0.002)是额外的危险因素。轴性近视作为单一因素与风险增加显著相关,但作为多因素时并非如此。总体而言,晶状体囊膜并发症后视网膜脱离的最终视力预后较差;3只眼的视力为0.50或更好。8只眼(62%)的最终视力低于0.10,6只眼的视力为0.02或更差。
白内障手术并发晶状体囊膜并发症后视网膜脱离的风险显著增加,大多数情况下导致最终视力较差。