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23G经结膜无缝线玻璃体切割联合白内障超声乳化吸出术后后囊膜混浊的相关因素

Factors contributing to posterior capsule opacification following 23-gauge transconjunctival phacovitrectomy.

作者信息

Rahman Rubina, Briffa Benedict Vella, Gupta Abha, Chinn David J

机构信息

Calderdale Royal Hospital, Halifax, United Kingdom.

出版信息

Ophthalmic Surg Lasers Imaging. 2011 May-Jun;42(3):229-33. doi: 10.3928/15428877-20110420-02.

Abstract

BACKGROUND AND OBJECTIVE

To determine posterior capsule opacification (PCO) rate and identify contributory factors in a series of patients undergoing combined 23-gauge transconjunctival phacovitrectomy.

PATIENTS AND METHODS

Retrospective data on 221 consecutive patients operated on by a single senior surgeon using a standard technique were collected and subjected to univariate analysis with chi-square tests and multivariate analysis with logistic regression.

RESULTS

PCO developed in 46 of 221 cases (20.8%). Major risk factors were: rhegmatogenous retinal detachment (relative risk = 3.3, P = .002), axial length greater than 24.5 mm (relative risk = 2.0, P = .093), intraoperative/postoperative complications (relative risk = 3.3, P = .04), C2F6 tamponade (versus SF6/air) (relative risk = 2.8, P = .01), and postoperative posturing (relative risk = 4.1, P < .001). Multiple logistic regression analysis showed the latter two to be most important.

CONCLUSION

PCO rate following 23-gauge phacovitrectomy is lower than most rates reported for 20-gauge phacovitrectomy. Using shorter-acting gas tamponade and avoiding postoperative posturing may help lower PCO rates.

摘要

背景与目的

确定接受23G经结膜无缝线白内障玻璃体切除术患者的后囊膜混浊(PCO)发生率,并识别相关因素。

患者与方法

收集由同一位资深外科医生采用标准技术连续手术的221例患者的回顾性数据,采用卡方检验进行单因素分析,并采用逻辑回归进行多因素分析。

结果

221例患者中有46例(20.8%)发生PCO。主要危险因素为:孔源性视网膜脱离(相对风险=3.3,P=0.002)、眼轴长度大于24.5mm(相对风险=2.0,P=0.093)、术中/术后并发症(相对风险=3.3,P=0.04)、C2F6气体填充(对比SF6/空气)(相对风险=2.8,P=0.01)以及术后体位(相对风险=4.1,P<0.001)。多因素逻辑回归分析显示后两者最为重要。

结论

23G白内障玻璃体切除术后的PCO发生率低于多数报道的20G白内障玻璃体切除术的发生率。使用短效气体填充并避免术后体位可能有助于降低PCO发生率。

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