Department of Opthalmology, Jules Stein Eye Institute, Los Angeles, California 90095, USA.
J Glaucoma. 2010 Feb;19(2):100-4.
To determine the prevalence of and risk factors for developing clinical cystoid macular edema (CME) after cataract surgery in patients with glaucoma.
Medical records of patients who had cataract surgery between April 1998 and July 2006 without prior history of CME, a known risk factor to develop CME, or previous nonglaucoma ocular laser procedures or intraocular surgeries were reviewed. Clinical CME was diagnosed by fundus examination within 3 months postoperatively and confirmed with fluorescein angiography or optical coherence tomography. Outcome measures included prevalence of clinical CME by comparing patients with and without glaucoma; and risk factor analysis for clinical CME by comparing patients who did and did not develop CME after cataract surgery.
Seven hundred patients (eyes) with glaucoma and 553 patients (eyes) without glaucoma were included. The prevalences of clinical CME in glaucoma and nonglaucoma patients were 5.14% and 5.79%, respectively (P=0.618). Patients who developed clinical CME (68 patients) had statistically higher rates of posterior capsule rupture or required anterior vitrectomy during surgery (P=0.010, odds ratio=3.35, 95% CI 1.33-8.45) compared with patients who did not develop clinical CME (1185 patients). No glaucoma medications used either preoperatively or postoperatively were associated with clinical CME (P>0.05).
Rupture of posterior capsule and anterior vitrectomy during cataract surgery is a potential risk factor for developing clinical CME after cataract surgery. There is no statistically significant difference in the prevalence of clinical CME after small corneal incision phacoemulsification cataract surgery between glaucoma and nonglaucoma patients.
确定青光眼患者白内障手术后发生临床型囊样黄斑水肿（CME）的患病率和相关危险因素。
回顾性分析 1998 年 4 月至 2006 年 7 月间行白内障手术、术前无 CME 病史（已知的 CME 发生危险因素）、既往无青光眼眼部激光治疗或眼内手术史的患者的病历资料。术后 3 个月内通过眼底检查诊断临床 CME，并通过荧光素血管造影或光学相干断层扫描进行确认。主要观察指标为比较青光眼和非青光眼患者的临床 CME 患病率；比较白内障手术后发生和未发生 CME 的患者的 CME 相关危险因素。
共纳入 700 例（700 只眼）青光眼患者和 553 例（553 只眼）非青光眼患者。青光眼和非青光眼患者的临床 CME 患病率分别为 5.14%和 5.79%（P=0.618）。与未发生临床 CME 的患者（1185 例）相比，发生临床 CME 的患者（68 例）术中后囊膜破裂或需要行前段玻璃体切割术的比例更高（P=0.010，优势比=3.35，95%可信区间 1.33~8.45）。术前和术后应用的任何青光眼药物与临床 CME 均无相关性（P>0.05）。
白内障手术中后囊膜破裂和前段玻璃体切割术是白内障手术后发生临床 CME 的潜在危险因素。小切口超声乳化白内障吸除术后，青光眼和非青光眼患者的临床 CME 患病率无统计学差异。
