Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Am J Ophthalmol. 2011 Oct;152(4):618-23. doi: 10.1016/j.ajo.2011.03.009. Epub 2011 Jun 17.
To estimate the long-term cumulative risk of late posterior chamber intraocular lens (IOL) dislocation after cataract extraction in a population-based cohort.
Retrospective cohort study and nested case-control study.
The records of all residents of Olmsted County, Minnesota, who underwent cataract extraction from January 1, 1980, through May 31, 2009, (14 471 cases in 9577 residents) and who were diagnosed with late posterior chamber IOL dislocation in the same period were reviewed. Cases were identified through the Rochester Epidemiology Project. Three controls chosen from the cataract surgery cohort were matched to each IOL dislocation case by age, gender, and duration of follow-up. Records were reviewed to confirm case status and to ascertain risk factor information. The cumulative risk of IOL dislocation was estimated by using the Kaplan-Meier method. Logistic regression models assessed differences between cases and controls.
We identified 16 cases of late posterior chamber IOL dislocation, 9 with in-the-bag dislocations and 7 with out-of-the-bag dislocations. At 5, 10, 15, 20, and 25 years after cataract extraction, the cumulative risk of IOL dislocation was 0.1%, 0.1%, 0.2%, 0.7%, and 1.7%, respectively. There was no significant difference in the risk of late IOL dislocation after extracapsular cataract extraction when compared with phacoemulsification (P = .21) or between different decades of surgery (P = .92). Pseudoexfoliation and zonular laxity at surgery were associated significantly with late IOL dislocation (P = .01).
The long-term cumulative risk of late IOL dislocation after cataract extraction was low and did not significantly change over our nearly 30-year study period.
在基于人群的队列中估计白内障摘除术后晚期后房型人工晶状体（IOL）脱位的长期累积风险。
回顾性队列研究和巢式病例对照研究。
回顾分析了 1980 年 1 月 1 日至 2009 年 5 月 31 日期间明尼苏达州奥姆斯特德县所有接受白内障摘除术的居民（9577 名居民中有 14471 例）的记录，同期诊断为晚期后房型 IOL 脱位。病例通过罗切斯特流行病学项目确定。从白内障手术队列中选择 3 名对照与每个 IOL 脱位病例按年龄、性别和随访时间匹配。审查记录以确认病例状态并确定危险因素信息。使用 Kaplan-Meier 方法估计 IOL 脱位的累积风险。逻辑回归模型评估病例与对照之间的差异。
我们确定了 16 例晚期后房型 IOL 脱位，9 例为袋内脱位，7 例为袋外脱位。白内障摘除后 5、10、15、20 和 25 年，IOL 脱位的累积风险分别为 0.1%、0.1%、0.2%、0.7%和 1.7%。与超声乳化术相比，囊外白内障摘除术的晚期 IOL 脱位风险无显著差异（P =.21）或不同手术十年间无显著差异（P =.92）。手术时的假性剥脱症和悬韧带松弛与晚期 IOL 脱位显著相关（P =.01）。
白内障摘除术后晚期 IOL 脱位的长期累积风险较低，在近 30 年的研究期间没有显著变化。
