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慢性葡萄膜炎患者前房人工晶状体植入的长期安全性和视觉效果。

Long-term safety and visual outcomes of anterior chamber intraocular lens implantation in patients with a history of chronic uveitis.

机构信息

Massachusetts Eye Research and Surgery Institution and Ocular Immunology and Uveitis Foundation, Cambridge, Massachusetts 02142, USA.

出版信息

J Cataract Refract Surg. 2012 Oct;38(10):1777-82. doi: 10.1016/j.jcrs.2012.05.037.

Abstract

PURPOSE

To compare the visual outcomes and prevalence of long-term complications in patients with quiescent uveitis after phacoemulsification with traditional in-the-bag intraocular lens (IOL) implantation versus primary or secondary anterior chamber (AC) IOL implantation due to inadequate capsule support.

SETTING

Single-center private practice.

DESIGN

Retrospective observational cohort study.

METHODS

Patients with quiescent uveitis who had cataract surgery with subsequent AC IOL implantation were identified through an electronic medical record database. They were age matched with patients with uveitis who had conventional placement of a posterior chamber (PC) IOL. The rate of postoperative complications and corrected distance visual acuity (CDVA) were reviewed preoperatively and 1, 3, and 6 months and 1, 2, 3, and 4 years postoperatively.

RESULTS

The incidence of postoperative complications was not statistically different for any criterion except posterior capsule opacification development in the PC IOL cohort (relative risk, 0.071). The mean follow-up was 36.11 months ± 17.3 (SD) in the AC IOL group and 53.72 ± 20.4 months in the PC IOL group. The mean preoperative CDVA was 1.49 ± 1.07 logMAR in the AC IOL group and 0.5 ± 0.26 logMAR in the PC IOL group. Both groups had a significant improvement in CDVA visual acuity 3 years postoperatively (P=.001 and P=.010 respectively).

CONCLUSIONS

In uveitic eyes with inadequate capsule support, AC IOL implantation was safe and effective in providing satisfactory improved CDVA without a significant increase in long-term complications compared with eyes that had PC IOL placement.

摘要

目的

比较白内障超声乳化术后因囊袋支持不足而行传统囊袋内人工晶状体(IOL)植入与原发性或继发性前房(AC)IOL 植入后静止性葡萄膜炎患者的视力结果和长期并发症的发生率。

设置

单中心私人诊所。

设计

回顾性观察队列研究。

方法

通过电子病历数据库确定接受白内障手术后行 AC IOL 植入的静止性葡萄膜炎患者,并与行后房型(PC)IOL 常规植入的葡萄膜炎患者进行年龄匹配。评估术前及术后 1、3 和 6 个月及 1、2、3 和 4 年的术后并发症发生率和矫正视力(CDVA)。

结果

除 PC IOL 组后发性白内障发展外,任何标准的术后并发症发生率均无统计学差异(相对风险,0.071)。AC IOL 组的平均随访时间为 36.11 ± 17.3 个月(标准差),PC IOL 组为 53.72 ± 20.4 个月。AC IOL 组术前 CDVA 平均为 1.49 ± 1.07 logMAR,PC IOL 组为 0.5 ± 0.26 logMAR。两组术后 3 年均有显著的 CDVA 视力改善(分别为 P=.001 和 P=.010)。

结论

在囊袋支持不足的葡萄膜炎眼中,与 PC IOL 植入相比,AC IOL 植入在提供令人满意的改善 CDVA 方面是安全有效的,并且长期并发症没有显著增加。

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