From the Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
From the Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
J Cataract Refract Surg. 2018 Jul;44(7):848-855. doi: 10.1016/j.jcrs.2018.03.034. Epub 2018 Jun 13.
To determine patient characteristics and outcomes for developing retained nuclear fragments in the anterior chamber after phacoemulsification in at-risk populations.
University of Arkansas for Medical Sciences, Jones Eye Institute, Little Rock, Arkansas, USA.
Retrospective case series.
Using Current Procedural Terminology codes 2006 to 2018, patients with a diagnosis of retained nuclear fragment in the anterior chamber after uncomplicated phacoemulsification cataract extraction were identified. Patient demographics, ocular biometrics, treatments, and clinical management were recorded. Main outcome measures were visual outcomes and visual acuity at regular follow-up appointments.
Nineteen patients (13 with myopia) were identified. Most patients (n = 15) presented with corneal edema and anterior chamber inflammation, and the fragments were diagnosed on slitlamp examination in most patients (n = 18). Seventeen retained fragments were found in the inferior angle. The mean axial length, keratometry, and anterior chamber depth (ACD) values were 23.58 mm, 44.93 diopters, and 2.97 mm, respectively. The mean time from cataract extraction to fragment removal was 34.7 days. The final corrected distance visual acuity ranged from 20/20 to 20/400. Three patients developed cystoid macular edema, and 2 patients had corneal complications after fragment removal.
A comparison between the patients in this study and cited cases indicates that long eyes, steep corneas, and a shallow ACD might be risk factors for retained nuclear fragments in patients having cataract extraction. Prompt identification and surgical removal provided the best visual outcomes because most cases proved refractory to steroid treatment.
确定在高危人群中，在超声乳化白内障吸除术后前房内遗留核碎片患者的特征和结局。
美国阿肯色大学医学科学分校，琼斯眼科研究所，小石城，阿肯色州，美国。
回顾性病例系列。
使用 2006 年至 2018 年的当前程序术语 (Current Procedural Terminology, CPT) 代码，确定了被诊断为超声乳化白内障吸除术后前房内遗留核碎片的患者。记录了患者的人口统计学、眼部生物测量学、治疗和临床管理。主要观察指标是视力结果和定期随访时的视力。
共确定了 19 名患者（13 名患有近视）。大多数患者（n=15）表现为角膜水肿和前房炎症，大多数患者（n=18）在裂隙灯检查中诊断出碎片。17 个遗留碎片位于下内角。平均眼轴长度、角膜曲率计和前房深度（anterior chamber depth, ACD）值分别为 23.58mm、44.93 屈光度和 2.97mm。从白内障摘除到碎片取出的平均时间为 34.7 天。最终矫正视力从 20/20 到 20/400 不等。3 名患者发生了囊样黄斑水肿，2 名患者在碎片取出后出现了角膜并发症。
与文献中报道的病例相比，本研究中的患者表明，长眼、陡峭的角膜和浅 ACD 可能是白内障摘除患者遗留核碎片的危险因素。及时识别和手术切除可提供最佳的视力结果，因为大多数病例对类固醇治疗效果不佳。
