Wong Chee Wai, Ang Marcus, Tsai Andrew, Phua Val, Lee Shu Yen
Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore.
Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Duke-NUS, Department of Ophthalmology and Visual Sciences, Singapore; Moorfields Eye Hospital, NHS Trust, London, United Kingdom.
Am J Ophthalmol. 2016 May;165:47-53. doi: 10.1016/j.ajo.2016.02.023. Epub 2016 Mar 3.
To assess time to stabilization and factors associated with changes in biometric parameters after scleral buckling (SB).
Prospective case series.
Seventeen eyes with primary rhegmatogenous retinal detachment (RRD) that underwent SB at the Singapore National Eye Centre were enrolled. SB surgery was performed using an encircling element and segmental buckle. Axial length (AL); anterior chamber depth (ACD), defined as the distance from the corneal epithelium to the anterior lens surface; anterior/posterior corneal curvature (K); and refraction were measured preoperatively and at week 1 and months 1, 3, 6, 9, and 12 postoperatively. Stability of each parameter was defined as the earliest time point at which there is no significant difference compared to its value at month 12.
AL increased (26.09 ± 1.46 to 26.51 ± 1.96, P = .01), ACD decreased (3.84 ± 0.47 to 3.32 ± 0.57, P < .001), and a myopic shift of 1.04 diopters (95% CI 0.03-2.05, P = .04) occurred at month 12. Anterior/posterior K were not significantly changed from baseline. AL stabilized at month 3 while ACD and spherical equivalent (SE) stabilized at week 1. Cryotherapy was associated with greater increase in AL (P = .001) and myopic shift (P = .02). More extensive segmental buckling was associated with greater increase in AL (P = .009) and myopic shift (P = .03).
Our study suggests that patients requiring cataract surgery after SB should have biometry performed no earlier than 3 months post SB surgery, and intraocular lens power calculation with a fourth-generation formula. A greater increase in AL and myopic shift was associated with cryotherapy and more extensive segmental buckling.
评估巩膜扣带术(SB)后生物测量参数稳定所需时间以及与这些参数变化相关的因素。
前瞻性病例系列研究。
纳入在新加坡国家眼科中心接受SB手术的17例原发性孔源性视网膜脱离(RRD)患者的患眼。采用环扎带和节段性扣带进行SB手术。术前及术后第1周、第1、3、6、9和12个月测量眼轴长度(AL)、前房深度(ACD,定义为角膜上皮至晶状体前表面的距离)、角膜前/后曲率(K)以及屈光状态。每个参数的稳定性定义为与术后12个月时的值相比无显著差异的最早时间点。
AL增加(从26.09± 1.46增至26.51± 1.96,P = .01),ACD减小(从3.84± 0.47降至3.32± 0.57,P < .001),术后12个月出现1.04屈光度的近视漂移(95% CI 0.03 - 2.05,P = .04)。角膜前/后K与基线相比无显著变化。AL在术后3个月稳定,而ACD和等效球镜度(SE)在术后第1周稳定。冷冻疗法与AL更大幅度增加(P = .001)及近视漂移(P = .02)相关。更广泛的节段性扣带与AL更大幅度增加(P = .009)及近视漂移(P = .03)相关。
我们的研究表明,SB术后需要进行白内障手术的患者,生物测量应在SB术后不早于3个月进行,并采用四代公式计算人工晶状体度数。AL更大幅度增加及近视漂移与冷冻疗法和更广泛的节段性扣带相关。