Park Yuli, Kim Min Hee, Won Jae Yon, Kim Hyun Seung, Park Young-Hoon
*Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; and †Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Retina. 2016 Nov;36(11):2110-2115. doi: 10.1097/IAE.0000000000001049.
To evaluate the time, incidence, and visual outcome of vitreoretinal complications after penetrating keratoplasty (PK).
A retrospective chart review of 1,594 eyes that underwent PK was conducted. Preoperative characteristics, visual significance, and postoperative vitreoretinal complications were analyzed.
The incidence of vitreoretinal complications after PK was 3.3% (52/1,594). The mean follow-up period was 38.5 ± 29.8 months. The mean time for vitreoretinal complications to occur was 4.8 months. The most common vitreoretinal complication was vitreous hemorrhage (0.75%), and others included choroidal detachment (0.7%), endophthalmitis (0.6%), and retinal detachment (0.5%). Majority of vitreous hemorrhage, endophthalmitis, and choroidal detachment occurred within 1 month postoperatively, but most cases of cystoid macular edema and epiretinal membrane occurred after 3 months. At follow-up after PK, the mean corrected distance visual acuity was worse among eyes that experienced vitreoretinal complications compared with eyes that did not (P = 0.013).
Vitreoretinal complications after PK occurred in a significant percentage, resulting in persistent reduction of corrected distance visual acuity. Given this, it is of particular importance to control intraoperative and postoperative intraocular pressure, infection, and inflammation which will contribute to decrease in the incidence of vitreoretinal complications after PK.
评估穿透性角膜移植术(PK)后玻璃体视网膜并发症的发生时间、发生率及视力预后。
对1594例行PK的患眼进行回顾性病历分析。分析术前特征、视力意义及术后玻璃体视网膜并发症。
PK后玻璃体视网膜并发症的发生率为3.3%(52/1594)。平均随访时间为38.5±29.8个月。玻璃体视网膜并发症发生的平均时间为4.8个月。最常见的玻璃体视网膜并发症是玻璃体积血(0.75%),其他包括脉络膜脱离(0.7%)、眼内炎(0.6%)和视网膜脱离(0.5%)。大多数玻璃体积血、眼内炎和脉络膜脱离发生在术后1个月内,但大多数黄斑囊样水肿和视网膜前膜病例发生在3个月后。在PK术后随访时,发生玻璃体视网膜并发症的患眼的平均矫正远视力比未发生并发症的患眼差(P = 0.013)。
PK后玻璃体视网膜并发症的发生率较高,导致矫正远视力持续下降。鉴于此,控制术中及术后眼压、感染和炎症对于降低PK后玻璃体视网膜并发症的发生率尤为重要。