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玻璃体切割术后角膜上皮缺损的相关因素。

Factors associated with corneal epithelial defects after pars plana vitrectomy.

作者信息

Chiang Wei-Yu, Lee Jong-Jer, Kuo Hsi-Kung, Chen Yi-Hao, Chen Chih-Hsin, Chen Yung-Jen, Wu Pei-Chang, Chen Yun-Wen

机构信息

Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, 83301, Taiwan.

出版信息

Int Ophthalmol. 2018 Feb;38(1):105-110. doi: 10.1007/s10792-016-0429-7. Epub 2017 Jan 3.

DOI:10.1007/s10792-016-0429-7
PMID:28050730
Abstract

PURPOSE

To investigate the risk factors associated with corneal epithelial defects (CED) and delayed healing (exceeding 1 week) following pars plana vitrectomy (PPV).

METHODS

This retrospective study enrolled patients who underwent PPV at a single center in Taiwan between 2011 and 2012. Medical records were reviewed, including demographic, underlying disease, surgical indication, operation parameters, and existence of CED. These data were statistically analyzed. All patients were evaluated during follow-ups at day 1 and week 1 after PPV. Patients with persistent CED 1 week after PPV were diagnosed with delayed healing.

RESULTS

A total of 255 patients were included in the study, consisting of 139 men and 116 women, with a mean age of 56.9 years. PPV was performed under the indications of rhegmatogenous retinal detachment (RRD), diabetic retinopathy, or vitreoretinal interface disease. Out of 255 eyes, 59 developed CED 1 day after surgery (23.1%), and CED was associated with younger age, diabetes mellitus (DM), RRD, longer duration of surgery, and silicon oil use during surgery. Among them, seven patients (11.9%) demonstrated delayed healing, which was associated with a higher rate of DM (p = 0.085), compared to patients who healed within 1 week.

CONCLUSION

Patients with RRD, longer duration of surgery, and DM may be at risk of developing CED after PPV. In addition, patients with DM demonstrated a higher incidence of delayed corneal healing.

摘要

目的

探讨玻璃体切割术(PPV)后角膜上皮缺损(CED)及延迟愈合(超过1周)的相关危险因素。

方法

本回顾性研究纳入了2011年至2012年在台湾某单一中心接受PPV的患者。回顾了病历,包括人口统计学资料、基础疾病、手术指征、手术参数以及CED的存在情况。对这些数据进行了统计分析。所有患者在PPV后第1天和第1周的随访中接受评估。PPV后1周仍有持续性CED的患者被诊断为延迟愈合。

结果

本研究共纳入255例患者,其中男性139例,女性116例,平均年龄56.9岁。PPV在孔源性视网膜脱离(RRD)、糖尿病视网膜病变或玻璃体视网膜界面疾病的指征下进行。在255只眼中,59只在术后1天出现CED(23.1%),CED与年龄较小、糖尿病(DM)、RRD、手术时间较长以及手术中使用硅油有关。其中,7例患者(11.9%)表现为延迟愈合,与1周内愈合的患者相比,DM发生率较高(p = 0.085)。

结论

RRD、手术时间较长和DM患者在PPV后可能有发生CED的风险。此外,DM患者角膜延迟愈合的发生率较高。

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本文引用的文献

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[Diabetic keratopathy: new progresses and challenges].[糖尿病性角膜病变:新进展与挑战]
Zhonghua Yan Ke Za Zhi. 2014 Jan;50(1):69-72.
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Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence.终末期肾病患者的高磷血症:评估当前证据将治疗依从性与结局联系起来。
Int J Ophthalmol. 2024 Jan 18;17(1):92-96. doi: 10.18240/ijo.2024.01.12. eCollection 2024.
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Optimized design of surgical steps in pars plana vitrectomy for macular hole retinal detachment in pathological myopia decreases rate of iatrogenic retinal break and shortens length of operation.病理性近视黄斑裂孔视网膜脱离患者行睫状体平坦部玻璃体切割术中手术步骤的优化设计可降低医源性视网膜裂孔的发生率,并缩短手术时间。
BMC Ophthalmol. 2023 Apr 11;23(1):150. doi: 10.1186/s12886-023-02907-3.
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Outcomes and predictors of vitrectomy and silicone oil tamponade in retinal detachments complicated by proliferative vitreoretinopathy.增生性玻璃体视网膜病变合并视网膜脱离行玻璃体切除术及硅油填充的疗效与预测因素
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