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一项关于三级教学医院白内障手术中植入囊袋张力环的适应证及手术结果的回顾性研究。

A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital.

作者信息

Wang Bob Z, Chan Elsie, Vajpayee Rasik B

机构信息

The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.

出版信息

Clin Ophthalmol. 2013;7:567-72. doi: 10.2147/OPTH.S38543. Epub 2013 Mar 19.

Abstract

BACKGROUND

The purpose was to determine preoperative indications, intraoperative procedures, and outcomes of capsular tension ring (CTR) insertion during cataract surgery.

METHODS

A review of all patients undergoing cataract surgery with insertion of a CTR between July 2000 and June 2010 was conducted at The Royal Victorian Eye and Ear Hospital, a large tertiary teaching hospital in Victoria, Australia. Information relating to each patient's demographic details, preoperative assessment, surgical procedure, and postoperative assessment were obtained.

RESULTS

Eighty-four eyes of 82 patients were included in this study. The main indications for CTR insertion were previous trauma, pseudoexfoliation syndrome, and mature cataracts. Twenty-one eyes (25.0%) did not have any obvious preoperative indication. A posterior capsule tear was the most common intraoperative complication (3.6%). An intraocular lens was successfully implanted in the bag in 72 eyes (85.7%). Postoperatively, the most common complications were a decentered intraocular lens (8.3%) and persistent corneal edema (6.0%). Overall, 61 eyes (72.6%) had better postoperative visual acuity compared with preoperative acuity, with 67 patients (79.8%) achieving vision of 20/40 or better.

CONCLUSION

For the majority of cases, CTR use in complex cataract surgeries is associated with improved postoperative outcomes. CTR implantation is most commonly required in patients with known risk factors for zonular instability.

摘要

背景

目的是确定白内障手术中植入囊袋张力环(CTR)的术前指征、术中操作及结果。

方法

对2000年7月至2010年6月期间在澳大利亚维多利亚州一家大型三级教学医院皇家维多利亚眼耳医院接受白内障手术并植入CTR的所有患者进行回顾。获取了每位患者的人口统计学细节、术前评估、手术过程及术后评估等相关信息。

结果

本研究纳入了82例患者的84只眼。植入CTR的主要指征为既往外伤、假性剥脱综合征和成熟白内障。21只眼(25.0%)术前无任何明显指征。后囊膜撕裂是最常见的术中并发症(3.6%)。72只眼(85.7%)的人工晶状体成功植入囊袋内。术后,最常见的并发症是人工晶状体偏心(8.3%)和持续性角膜水肿(6.0%)。总体而言,61只眼(72.6%)术后视力较术前有所提高,67例患者(79.8%)视力达到20/40或更好。

结论

对于大多数病例,在复杂白内障手术中使用CTR可改善术后结果。已知存在悬韧带不稳定危险因素的患者最常需要植入CTR。

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