Thevi Thanigasalam, Abas Adinegara Lutfi
Department of Ophthalmology, Hospital Melaka, Melaka, Malaysia.
Department of Community Medicine, Melaka Manipal Medical College, Melaka, Malaysia.
Oman J Ophthalmol. 2018 May-Aug;11(2):113-118. doi: 10.4103/ojo.OJO_220_2016.
Cataract surgery is associated with a variety of complications, one of which is vitreous loss. Doctors and policymakers should be aware about the precipitating factors, associations, and expected outcomes of vitreous loss. This study was, therefore, undertaken to set guidelines to improve the visual outcomes of patients.
A retrospective 8-year analysis was conducted from 2007 to 2014 using the national eye database. Demographic features, ocular comorbidities, grade of surgeon, type of surgery, and the associations with the occurrence of vitreous loss, and the final visual outcomes of these patients were studied.
Out of 12,992 eyes, only 3.2% had vitreous loss, mostly aged <40 years. Pseudoexfoliation was the only ocular comorbidity causing vitreous loss. Medical Officers and Gazetting Specialists got more vitreous loss compared to specialists. Intracapsular cataract extraction, phaco convert to extracapsular cataract extraction (ECCE), ECCE, and phaco all had a significant vitreous loss. Vitreous loss was the most significant intraoperative complication causing poor vision and resulted in impaired or poor visual outcome.
Vitreous loss occurred in almost all types of cataract surgeries, especially by junior surgeons, among those aged <40 years and significantly caused poor visual outcome compared to other complications. Pseudoexfoliation had higher occurrence of vitreous loss. Vitreous loss patients had impaired/poor visual outcome due to preexisting comorbidity and astigmatism. Patients at risk and junior surgeons should be closely monitored to improve outcomes. Further studies need to be done to see why and when the vitreous loss occurred.
白内障手术会引发多种并发症，其中之一是玻璃体脱出。医生和政策制定者应了解玻璃体脱出的诱发因素、关联因素及预期结果。因此，开展本研究以制定改善患者视觉效果的指南。
利用国家眼科数据库对2007年至2014年进行了为期8年的回顾性分析。研究了患者的人口统计学特征、眼部合并症、手术医生级别、手术类型、与玻璃体脱出发生的关联以及这些患者的最终视觉效果。
在12992只眼中，仅有3.2%发生了玻璃体脱出，其中大多数年龄小于40岁。假性剥脱是导致玻璃体脱出的唯一眼部合并症。与专科医生相比，医务官和准专科医生发生玻璃体脱出的情况更多。囊内白内障摘除术、超声乳化转为囊外白内障摘除术（ECCE）、ECCE和超声乳化均有显著的玻璃体脱出。玻璃体脱出是导致视力不佳的最主要术中并发症，会导致视力受损或视觉效果差。
几乎所有类型的白内障手术都会发生玻璃体脱出，尤其是年轻外科医生进行的手术，在年龄小于40岁的患者中更为常见，与其他并发症相比，显著导致视觉效果差。假性剥脱导致玻璃体脱出的发生率更高。由于存在合并症和散光，玻璃体脱出患者的视力受损/视觉效果差。应密切监测高危患者和年轻外科医生，以改善手术效果。需要进一步研究以明确玻璃体脱出发生的原因和时间。
