Miao Pei-jian, Li Wen-sheng, Zheng Jing-wei, Wu Rong-han, Xu Ming
School of Optometry and Ophthalmology, Eye Hospital, Wenzhou Medical College, Wenzhou, China.
Zhonghua Yi Xue Za Zhi. 2009 Sep 22;89(35):2462-7.
To investigate the incidence and related factors of retinal detachment (RD) after phacoemulsification cataract extraction and intraocular lens (IOL) implantation in an unselected patient group.
This retrospective review was comprised of 10 076 cataract patients (13 625 eyes) who had phacoemulsification cataract extraction and IOL implantation from December 1, 1998 to September 30, 2008. The patients were of different ages, gender, left or right eye and different type of cataracts. The incidence of postoperative RD was assessed and the relative risk factors were estimated using the Kaplan-Meier method.
The average age was 67.22 +/- 15.10 years old with 4439 males and 5637 females. The difference between the numbers of men and women was statistically significant (chi(2) = 142.44, P < 0.01). A total of 6701 left eyes and 6924 right eyes showed no significant difference (chi(2) = 3.65, P = 0.056). And 65.91% of these eyes were age-related cataract. During the post-operation observation period, 32 eyes of RD in 32 patients were observed from 10 days to 74 months post-operation. The ratio was 0.32% with an estimated risk (Kaplan-Meier) of 0.47% at 74 months. These results confirmed that myopia and increased axial length were significantly associated with RD (chi(2) = 14.55, P < 0.001) and recognized risk factors for RD such as high myopia, posterior capsular bag rupture and Nd: YAG capsulotomy. Among these 32 eyes, 31 eyes had one successful retina re-attaching operation (90.32%) and two eyes were given up because of post-operative relapse.
The incidence of RD increases after phacoemulsification cataract extraction and IOL implantation in an unselected patient group. Hypermyopia, posterior capsular bag rupture and Nd: YAG capsulotomy are possible risk factors of the RD.
在未经过挑选的患者群体中,调查白内障超声乳化吸除联合人工晶状体(IOL)植入术后视网膜脱离(RD)的发生率及相关因素。
这项回顾性研究纳入了1998年12月1日至2008年9月30日期间接受白内障超声乳化吸除联合IOL植入术的10076例白内障患者(13625只眼)。这些患者年龄、性别、眼别(左眼或右眼)以及白内障类型各异。评估术后RD的发生率,并使用Kaplan-Meier法估算相关危险因素。
平均年龄为67.22±15.10岁,男性4439例,女性5637例。男女数量差异具有统计学意义(χ² = 142.44,P < 0.01)。共6701只左眼和6924只右眼,差异无统计学意义(χ² = 3.65,P = 0.056)。其中65.91%的眼睛为年龄相关性白内障。在术后观察期内,术后10天至74个月观察到32例患者的32只眼发生RD。发生率为0.32%,74个月时的估计风险(Kaplan-Meier法)为0.47%。这些结果证实近视和眼轴长度增加与RD显著相关(χ² = 14.55,P < 0.001),以及公认的RD危险因素,如高度近视、后囊袋破裂和Nd:YAG后囊切开术。在这32只眼中,31只眼成功进行了一次视网膜复位手术(90.32%),2只眼因术后复发而放弃治疗。
在未经过挑选的患者群体中,白内障超声乳化吸除联合IOL植入术后RD的发生率增加。高度近视、后囊袋破裂和Nd:YAG后囊切开术可能是RD的危险因素。