Kam Andrew W, Chen Tony S, Wang Sarah B, Jain Neeranjali S, Goh Aaron Yj, Douglas Christopher P, McKelvie Penny A, Agar Ashish, Osher Robert H, Francis Ian C
Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
The University of New South Wales, Sydney, New South Wales, Australia.
Clin Exp Ophthalmol. 2016 Dec;44(9):797-802. doi: 10.1111/ceo.12791. Epub 2016 Jul 20.
To identify and classify materials in the vitreous observed during phacoemulsification cataract surgery (phaco).
Prospective, consecutive, observational case series at one ophthalmic day surgery in Sydney, Australia.
A total of 767 consecutive phaco cases. Cases were excluded if there was posterior capsule rupture or vitreous loss intraoperatively.
For each patient, age, gender, baseline corrected distance visual acuity, presence of pseudoexfoliation, nuclear sclerosis grade and phacoemulsification ultrasound time were recorded. The relationship between these variables and materials in the vitreous was evaluated with regression analysis. Two patients with materials in the vitreous developed an acute intraoperative rock-hard eye syndrome. In these two patients, pars plana needle aspiration of retrolenticular fluid was performed to re-establish normal intraocular pressure. Histology was undertaken to compare this fluid with known lens material retrieved from the Fluid Management System bags in two unrelated cases.
Presence of materials in the vitreous during phaco.
Materials in the vitreous were observed in either Berger's space or the anterior vitreous in 386 eyes (50.3% of cases); the majority was putatively lens material (46.5% of all cases). Pigment and ophthalmic viscoelastic device were seen in the anterior vitreous in 9.8% and 1.7% of cases, respectively. Logistic regression analysis demonstrated that higher nuclear sclerosis grade (P = 0.025), male gender (P = 0.003) and greater age (P = 0.016) were predictive of the presence of materials in the vitreous. Histological assessment with light microscopy and birefringence techniques identified the materials in the vitreous as lens material.
Materials in the vitreous were seen in 50.3% of phaco cases. It has been histologically demonstrated that lens materials can be introduced into the anterior vitreous during phaco.
识别并分类在白内障超声乳化手术（phaco）过程中观察到的玻璃体中的物质。
在澳大利亚悉尼的一家眼科日间手术中心进行的前瞻性、连续性、观察性病例系列研究。
共767例连续性phaco病例。术中出现后囊破裂或玻璃体丢失的病例被排除。
记录每位患者的年龄、性别、基线矫正远视力、是否存在假性剥脱、核硬化分级以及超声乳化手术时间。通过回归分析评估这些变量与玻璃体中物质的关系。两名玻璃体中有物质的患者出现了急性术中眼球坚硬综合征。对这两名患者进行了晶状体平面针吸术以抽取晶状体后液体，从而恢复正常眼压。进行组织学检查，将该液体与从两个不相关病例的液体管理系统袋中获取的已知晶状体物质进行比较。
phaco过程中玻璃体中物质的存在情况。
在386只眼中（占病例的50.3%），在伯杰间隙或前玻璃体中观察到玻璃体中有物质；大多数推测为晶状体物质（占所有病例的46.5%）。分别有9.8%和1.7%的病例在前玻璃体中发现色素和眼科粘弹性装置。逻辑回归分析表明，较高的核硬化分级（P = 0.025）、男性（P = 0.003）和较大年龄（P = 0.016）是玻璃体中存在物质的预测因素。通过光学显微镜和双折射技术进行的组织学评估确定玻璃体中的物质为晶状体物质。
50.3%的phaco病例中观察到玻璃体中有物质。组织学已证实，在phaco过程中晶状体物质可进入前玻璃体。
