Tabatabaei S A, Rajabi M B, Tabatabaei S M, Soleimani M, Rahimi F, Yaseri M
Ocular Trauma and Emergency, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Eye (Lond). 2017 Aug;31(8):1199-1204. doi: 10.1038/eye.2017.57. Epub 2017 Apr 14.
PurposeTo determine the proper time for traumatic cataract surgery after open globe injuries.SettingFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.DesignRandomized clinical trial.Patients and methodsIn a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed.ResultsBest-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group (P=0.069). On the other hand, zonulysis was significantly higher in the late procedure group (P=0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups.ConclusionsEarly and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.
目的
确定开放性眼球损伤后外伤性白内障手术的合适时机。
地点
伊朗德黑兰医科大学法拉比眼科医院。
设计
随机临床试验。
患者和方法
在一项随机临床试验中，30例开放性眼球损伤后外伤性白内障并植入人工晶状体的患者接受了早期手术（创伤后第一周），30例患者接受了晚期白内障手术（创伤后第一至第二个月）。我们排除了12岁以下的患者。所有患者在术后1周、4周、12周和6个月进行随访。每次随访时，对患者进行视力、眼压（IOP）、前房炎症、人工晶状体位置和后粘连检查。此外，进行了眼后段评估和眼底检查。记录术中并发症，包括后囊破裂、前部玻璃体切除术和悬韧带松解以及人工晶状体植入部位，并列出术后并发症，包括眼压升高、前房炎症、视轴混浊、后粘连、人工晶状体半脱位和人工晶状体色素沉着。
结果
两组术后6个月的最佳矫正视力无差异。此外，早期白内障手术组后囊破裂率并不显著高于晚期手术组（P = 0.069）。另一方面，晚期手术组悬韧带松解率显著更高（P = 0.039）。两组的其他并发症，包括前部玻璃体切除术、眼压升高、前房炎症、视轴混浊、后粘连、人工晶状体半脱位和人工晶状体色素沉着无差异。
结论
开放性眼球损伤后早期和晚期外伤性白内障手术及人工晶状体植入，在术后最佳矫正视力以及主要的术中和术后并发症方面无显著差异。
