Ohtsuka Eye Hospital, Sapporo, Japan.
Ophthalmology. 2012 Oct;119(10):2102-7. doi: 10.1016/j.ophtha.2012.03.050. Epub 2012 Jun 19.
To determine when posterior vitreous detachments (PVDs) develop after phacoemulsification and aspiration combined with foldable intraocular lens implantation.
Prospective, consecutive case series.
A total of 575 eyes without a PVD preoperatively were studied prospectively and followed for 3 years after uneventful phacoemulsification surgery.
All patients underwent a comprehensive ocular examination, including a dynamic vitreous examination using biomicroscopy with and without a preset lens and a preoperative retinal examination on the day of surgery; the day postoperatively; 1 week and 1, 3, 6, and 12 months postoperatively; and every 6 months for 3 years postoperatively. The patients were divided into groups and analyzed on the basis of age and refractive error or axial length.
The cumulative incidence rates of eyes that developed PVD for 3 years postoperatively at each postoperative time point.
The cumulative numbers and percentages of eyes that developed a PVD were 6 (1.0%), 18 (3.1%), 31 (5.4%), 45 (7.8%), 63 (11.0%), 88 (15.3%), 106 (18.4%), 133 (23.1%), and 172 (30.0%) within 1 week and 1, 3, 6, 12, 18, 24, 30, and 36 months, respectively. Eleven (6.4%) of the 172 eyes in which a PVD developed during the follow-up period had new retinal breaks with or without a retinal detachment. Eight (15.4%) of 52 eyes with lattice degeneration and 3 (2.5%) of 120 eyes without lattice degeneration had retinal breaks associated with a PVD; these percentages were significant (P = 0.003).
Development of PVDs seems to accelerate after phacoemulsification and linearly accumulated for 3 years postoperatively. Approximately 6% of eyes with a PVD had retinal breaks and eyes with lattice degeneration had a 6.2-fold higher risk of developing retinal breaks associated with a PVD. Long-term follow-up is needed after phacoemulsification is performed.
确定超声乳化白内障吸除联合折叠式人工晶状体植入术后后玻璃体脱离（PVD）的发生时间。
前瞻性连续病例系列。
共 575 例术前无 PVD 的患者进行前瞻性研究，并在超声乳化白内障吸除术后 3 年进行随访。
所有患者均接受全面眼部检查，包括使用带有和不带有预设镜片的生物显微镜进行动态玻璃体检查，以及手术当天、术后第 1 天、术后第 1 周和第 1、3、6 和 12 个月进行术前视网膜检查；并在术后 3 年内每 6 个月进行一次检查。根据年龄和屈光不正或眼轴长度将患者分为不同组进行分析。
术后各时间点 3 年内发生 PVD 的眼的累积发生率。
术后 1 周和 1、3、6、12、18、24、30 和 36 个月时发生 PVD 的眼的累积例数和百分比分别为 6（1.0%）、18（3.1%）、31（5.4%）、45（7.8%）、63（11.0%）、88（15.3%）、106（18.4%）、133（23.1%）和 172（30.0%）。在随访期间发生 PVD 的 172 只眼中，有 11 只（6.4%）出现新的视网膜裂孔，伴或不伴视网膜脱离。有格子样变性的 52 只眼中有 8 只（15.4%）和无格子样变性的 120 只眼中有 3 只（2.5%）发生与 PVD 相关的视网膜裂孔，差异有统计学意义（P = 0.003）。
超声乳化白内障吸除术后 PVD 的发生似乎加速，并在术后 3 年内呈线性累积。约 6%的 PVD 眼出现视网膜裂孔，有格子样变性的眼发生与 PVD 相关的视网膜裂孔的风险增加 6.2 倍。超声乳化白内障吸除术后需要长期随访。
