Erçalık Nimet Yeşim, Yenerel Nursal Melda, Sanisoğlu Hüseyin Avni, Kumral Esra Türkseven, İmamoğlu Serhat
Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey.
Saudi J Ophthalmol. 2017 Oct-Dec;31(4):238-242. doi: 10.1016/j.sjopt.2017.04.005. Epub 2017 Apr 20.
To evaluate the intra- and postoperative complications of phacoemulsification in sequential and combined procedures of 23-gauge vitrectomy and cataract surgery.
The medical records of 376 patients who underwent phacoemulsification in a vitrectomized eye (sequential group) and 458 patients who underwent combined vitrectomy and phacoemulsification (combined group) were retrospectively reviewed. Main outcome measures were intra- and postoperative complications of phacoemulsification surgery. Surgical indications were a progressed cataract with various retinal conditions.
The most common intraoperative complication during phacoemulsification was posterior capsule rupture in both groups. The rate of this complication was higher in the sequential group (18 eyes, 4.8%) than in the combined group (7 eyes, 1.5%) ( = 0.006). The most common early postoperative complication was transient high intraocular pressure (68 eyes, 14.8%) and late postoperative complication was pupillary in the synechia combined group (82 eyes, 17.9%). The most common early postoperative complication was transient high intraocular pressure (29 eyes, 7.7%) and late postoperative complication was posterior capsule opacification (27 eyes, 7.2%) in the sequential group. Fibrinous exudation occurred more in the combined group (57 eyes, 12.4%) than in the sequential group (19 eyes, 5.1%) ( = 0.000).
Both sequential and combined cataract surgeries seemed to be safe. Combined surgery could be preferred in harder cataracts and zonular dehiscence.
评估23G玻璃体切除术和白内障手术的序贯及联合手术中超声乳化的术中及术后并发症。
回顾性分析376例在玻璃体切除术后眼内行超声乳化术患者（序贯组）和458例行玻璃体切除术联合超声乳化术患者（联合组）的病历。主要观察指标为超声乳化手术的术中及术后并发症。手术适应证为伴有各种视网膜病变的进展期白内障。
两组超声乳化术中最常见的并发症均为后囊膜破裂。该并发症发生率序贯组（18只眼，4.8%）高于联合组（7只眼，1.5%）（P = 0.006）。联合组术后早期最常见的并发症为短暂性高眼压（68只眼，14.8%），术后晚期并发症为瞳孔粘连（82只眼，17.9%）。序贯组术后早期最常见的并发症为短暂性高眼压（29只眼，7.7%），术后晚期并发症为后囊膜混浊（27只眼，7.2%）。联合组纤维蛋白渗出发生率（57只眼，12.4%）高于序贯组（19只眼，5.1%）（P = 0.000）。
序贯和联合白内障手术似乎都是安全的。对于较硬的白内障和晶状体悬韧带松弛，联合手术可能更可取。
