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既往存在的视网膜前膜与人工晶状体眼黄斑囊样水肿相关。

Preexisting epiretinal membrane is associated with pseudophakic cystoid macular edema.

作者信息

Schaub Friederike, Adler Werner, Enders Philip, Koenig Meike C, Koch Konrad R, Cursiefen Claus, Kirchhof Bernd, Heindl Ludwig M

机构信息

Department of Ophthalmology, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.

Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2018 May;256(5):909-917. doi: 10.1007/s00417-018-3954-4. Epub 2018 Mar 21.

Abstract

PURPOSE

The purpose of the present study was to evaluate whether preexisting epiretinal membrane (ERM) is a significant risk factor for developing pseudophakic cystoid macular edema (PCME).

METHODS

Two hundred four consecutive eyes and 153 consecutive eyes without preexisting epiretinal membranes were retrospectively compared regarding PCME development following phacoemulsification with posterior chamber lens implantation. Patients with vascular retinal diseases, uveitis, trauma, neovascular macular degeneration, chronic inflammatory conditions, diabetic retinopathy, endophthalmitis, eventful cataract surgery, and combination of cataract surgery and vitrectomy during the observation period were excluded. Macular examination was performed using spectral-domain optical coherence tomography (SD-OCT) before as well as at 4, 8, 12, 16, 24, and 36 weeks after cataract surgery. Univariate and multivariate logistic regression analyses were calculated.

RESULTS

PCME occurred in 32 of 204 eyes with preexisting ERM (15.7%), whereas 9 of 153 eyes without preexisting ERM (5.9%) developed PCME. The risk of PCME was significantly increased in eyes with ERM (p = 0.007). By multivariate logistic regression analysis, factors predictive of PCME included the history of previous pars plana vitrectomy for retinal detachment (odds ratio (OR) 3.619 [95% confidence interval (CI) 1.242 to 10.258]; p = 0.016) as well as the preexistence of ERM (OR 3.885 [95% CI 1.162 to 17.762]; p = 0.04).

CONCLUSION

Preexisting ERM seems to be associated with an increased risk of PCME following cataract surgery. Therefore, this risk should be considered in surgery planning, preoperative medication, and follow-up care after surgery.

摘要

目的

本研究旨在评估既往存在的视网膜前膜(ERM)是否为发生人工晶状体性黄斑囊样水肿(PCME)的重要危险因素。

方法

回顾性比较204只连续眼和153只无既往视网膜前膜的连续眼在白内障超声乳化联合后房型人工晶状体植入术后PCME的发生情况。排除观察期内患有视网膜血管疾病、葡萄膜炎、外伤、新生血管性黄斑变性、慢性炎症性疾病、糖尿病性视网膜病变、眼内炎、复杂白内障手术以及白内障手术联合玻璃体切除术的患者。在白内障手术前以及术后4、8、12、16、24和36周使用光谱域光学相干断层扫描(SD - OCT)进行黄斑检查。进行单因素和多因素逻辑回归分析。

结果

204只存在既往ERM的眼中有32只(15.7%)发生PCME,而153只无既往ERM的眼中有9只(5.9%)发生PCME。存在ERM的眼发生PCME的风险显著增加(p = 0.007)。通过多因素逻辑回归分析,预测PCME的因素包括既往因视网膜脱离行玻璃体切除术的病史(比值比(OR)3.619 [95%置信区间(CI)1.242至10.258];p = 0.016)以及ERM的存在(OR 3.885 [95% CI 1.162至17.762];p = 0.04)。

结论

既往存在的ERM似乎与白内障手术后PCME风险增加有关。因此,在手术规划、术前用药和术后随访中应考虑到这种风险。

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