Herrmann W A, Heimann H, Helbig H
Augenklinik, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Deutschland.
Ophthalmologe. 2010 Oct;107(10):975-84; quiz 985-6. doi: 10.1007/s00347-010-2236-2.
Cataract surgery is a safe procedure with a high patient satisfaction rate. However, pseudophakia changes the physiology of the eye and immediate changes include release of inflammatory cytokines. Deformation of the globe and intraoperative fluctuations of intraocular pressure may induce microlesions and alterations of ocular perfusion. The barrier function between the anterior and the posterior segment is compromised after surgery and the geometry of the intraocular chambers changes. Especially the vitreous body is subject to increased destruction during the years after surgery. The occurrence of pseudophakic cystoid macular edema after cataract surgery is a well known complication. Several studies have described a progression of diabetic retinopathy, especially of diabetic macular edema after cataract surgery. In contrast cataract surgery does not seem to have a significant impact on the progression of age-related macular degeneration. However the risk for retinal detachment is significantly increased in pseudophakia for at least 10 years after surgery. Awareness of special risk factors can make cataract surgery, one of the most effective procedures in medicine, even safer.
白内障手术是一种安全的手术，患者满意度很高。然而，人工晶状体改变了眼睛的生理结构，直接的变化包括炎性细胞因子的释放。眼球变形和术中眼压波动可能会导致微损伤和眼部灌注改变。手术会破坏眼前段和眼后段之间的屏障功能，眼内房水的几何形状也会发生变化。特别是在术后数年，玻璃体受到的破坏会增加。白内障手术后发生人工晶状体性黄斑囊样水肿是一种众所周知的并发症。多项研究描述了糖尿病视网膜病变的进展，尤其是白内障手术后糖尿病性黄斑水肿的进展。相比之下，白内障手术似乎对年龄相关性黄斑变性的进展没有显著影响。然而，人工晶状体眼发生视网膜脱离的风险在术后至少10年内会显著增加。了解特殊风险因素可以使白内障手术（医学上最有效的手术之一）更加安全。
