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平坦部玻璃体切除术及白内障超声乳化吸除联合玻璃体切除术术后的角膜内皮细胞丢失

Corneal endothelial cell loss after pars plana vitrectomy and combined phacoemulsification-vitrectomy surgeries.

作者信息

Koushan Keyvan, Mikhail Mikel, Beattie Anne, Ahuja Nina, Liszauer Allan, Kobetz Lawrence, Farrokhyar Forough, Martin James A

机构信息

St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ont; University of Toronto, Toronto, Ont.

Department of Ophthalmology, McGill University, Montreal, Que.

出版信息

Can J Ophthalmol. 2017 Feb;52(1):4-8. doi: 10.1016/j.jcjo.2016.06.001. Epub 2016 Oct 1.

Abstract

OBJECTIVE

To compare postoperative corneal endothelial cell density (ECD) loss in eyes undergoing pars plana vitrectomy (PPV), or combination of cataract extraction (using phacoemulsification) and intraocular lens implantation with vitrectomy (CE/IOL-PPV) surgeries.

METHODS

Institutional setting. Best-corrected visual acuity (BCVA) and ECD by specular microscopy were measured preoperatively and 3 months postoperatively in both groups. Relative postoperative ECD loss was the primary outcome measure. Change in BCVA was the secondary outcome measure.

RESULTS

Forty eyes of 40 patients undergoing PPV and 46 eyes of 46 patients undergoing CE/IOL-PPV were included in the final analysis. Postoperative ECD was decreased slightly more in the CE/IOL-PPV group compared with the PPV group (13.9% ± 15.5% vs 9.0% ± 14.6%), although this was not statistically significant (p = 0.10). The improvement in the logMAR BCVA was, however, statistically more significant in the CE/IOL-PPV group compared with the PPV group (-56.6% ± 24.3% vs -38.6% ± 45.5%, p = 0.04).

CONCLUSIONS

PPV and the combination CE/IOL-PPV surgeries lead to modest and statistically similar postoperative decline in ECD. The combination surgery may lead to slightly more postoperative cells loss, but also more improvement in visual acuity.

摘要

目的

比较接受玻璃体切割术(PPV)或白内障摘除(采用超声乳化术)联合人工晶状体植入术与玻璃体切割术(CE/IOL-PPV)的患者术后角膜内皮细胞密度(ECD)的损失情况。

方法

机构研究。术前及术后3个月测量两组患者的最佳矫正视力(BCVA)和通过镜面显微镜检查的ECD。术后ECD相对损失是主要观察指标。BCVA的变化是次要观察指标。

结果

最终分析纳入了40例接受PPV的患者的40只眼和46例接受CE/IOL-PPV的患者的46只眼。CE/IOL-PPV组术后ECD的下降幅度略高于PPV组(13.9%±15.5%对9.0%±14.6%),尽管差异无统计学意义(p = 0.10)。然而,与PPV组相比,CE/IOL-PPV组logMAR BCVA的改善在统计学上更显著(-56.6%±24.3%对-38.6%±45.5%,p = 0.04)。

结论

PPV和CE/IOL-PPV联合手术导致术后ECD出现适度且在统计学上相似的下降。联合手术可能导致术后细胞损失略多,但视力改善也更多。

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