Turalba Angela, Cakiner-Egilmez Tulay, Payal Abhishek R, Gonzalez-Gonzalez Luis A, Chomsky Amy S, Vollman David E, Baze Elizabeth F, Lawrence Mary G, Daly Mary K
Veterans Affairs Boston Healthcare System, Ophthalmology Department, Jamaica Plain, MA; Harvard Medical School, Department of Ophthalmology, Boston, MA.
Veterans Affairs Boston Healthcare System, Ophthalmology Department, Jamaica Plain, MA.
Can J Ophthalmol. 2017 Feb;52(1):61-68. doi: 10.1016/j.jcjo.2016.07.019. Epub 2016 Dec 7.
To compare clinical outcomes of cataract surgery in eyes with and without pseudoexfoliation (PXF).
Retrospective deidentified data analysis.
A total of 123 PXF and 4776 non-PXF eyes of patients who underwent cataract surgery.
We compared data on visual acuity, Visual Function Questionnaire (VFQ)-based quality of life, and complications in PXF and non-PXF eyes from the Veterans Affairs (VA) Ophthalmic Surgery Outcomes Data Project across 5 VA medical centres.
Pupillary expansion devices were used in 31 (25.2%) PXF cases and 398 (8.4%) non-PXF cases (p < 0.0001). Capsular tension rings were used in 6 (4.9%) PXF cases and 55 (1.2%) non-PXF cases (p < 0.004). The following complications occurred more frequently in PXF cases: zonular dehiscence without vitrectomy (4 [3.3%] PXF cases vs 40 [0.8%] non-PXF cases p = 0.02), persistent inflammation (28 [24.1%] vs 668 [14.5%]; p = 0.007), and persistent intraocular pressure elevation (5 [4.3%] vs 68 [1.5%]; p = 0.03). Best corrected visual acuity (BCVA) improved in both groups after 1 month, but 87 (83.7%) PXF cases achieved postoperative BCVA better than or equal to 20/40 compared to 3991 (93.8%) non-PXF cases (p = 0.0003). There was no significant difference in the postoperative composite VFQ scores between PXF (82.1 ± 16.9) and non-PXF cases (84.2 ± 16.8, p = 0.09).
Several complications occurred more frequently in the PXF group compared to the non-PXF group, and fewer PXF cases achieved BCVA better than or equal to 20/40. Despite this, both groups experienced similar improvement in vision-related quality of life after cataract surgery.
比较有和没有假性剥脱（PXF）的眼睛白内障手术的临床结果。
回顾性匿名数据分析。
共有123例接受白内障手术患者的PXF眼睛和4776例非PXF眼睛。
我们比较了来自5个退伍军人事务（VA）医疗中心的VA眼科手术结果数据项目中PXF和非PXF眼睛的视力、基于视觉功能问卷（VFQ）的生活质量及并发症数据。
31例（25.2%）PXF病例和398例（8.4%）非PXF病例使用了瞳孔扩张装置（p<0.0001）。6例（4.9%）PXF病例和55例（1.2%）非PXF病例使用了囊袋张力环（p<0.004）。以下并发症在PXF病例中更频繁发生：未行玻璃体切除术的晶状体悬韧带裂开（4例[3.3%]PXF病例 vs 40例[0.8%]非PXF病例，p = 0.02）、持续性炎症（28例[24.1%] vs 668例[14.5%]；p = 0.007）和持续性眼压升高（5例[4.3%] vs 68例[1.5%]；p = 0.03）。两组术后1个月最佳矫正视力（BCVA）均有改善，但87例（83.7%）PXF病例术后BCVA达到或优于20/40，相比之下非PXF病例有3991例（93.8%）（p = 0.0003）。PXF组（82.1±16.9）和非PXF病例组（84.2±16.8，p = 0.09）术后综合VFQ评分无显著差异。
与非PXF组相比，PXF组几种并发症更频繁发生，且达到BCVA优于或等于20/40的PXF病例更少。尽管如此，两组白内障手术后与视力相关的生活质量改善相似。
