Department of Ophthalmology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
PLoS One. 2019 Mar 8;14(3):e0213457. doi: 10.1371/journal.pone.0213457. eCollection 2019.
To evaluate the efficacy and safety of posterior capsulotomy by analyzing the long-term visual outcomes in patients with rhegmatogenous retinal detachment (RD), who underwent combined phaco-vitrectomy with or without primary posterior capsulotomy.
A retrospective longitudinal cohort analysis was performed by using data of rhegmatogenous RD patients undergoing combined phaco-vitrectomy. Patients were divided into two groups; Group A (68 eyes of 68 patients) with capsulotomy, and Group B (39 eyes of 39 patients) without capsulotomy. We reviewed the best-corrected visual acuity (BCVA), incidence of posterior capsule opacification (PCO), clinical features at the diagnosis of rhegmatogenous RD, and intraoperative or postoperative complications following posterior capsulotomy.
The modified BCVA measured by the logarithm of the minimum angle of resolution at initial diagnosis and 3, 6, and 12 months after surgery was 0.67 in Group A versus 0.85 in Group B (p = 0.258), 0.40 in Group A versus 0.50 in Group B (p = 0.309), 0.27 in Group A versus 0.45 in Group B (p = 0.055), and 0.21 in Group A versus 0.47 in Group B (p = 0.014), respectively. In subgroup with macula-on RRD, Group A exhibited better visual outcomes compared to Group B at 6(0.17 versus 0.40 [p = 0.037]) and at 12 months(0.14 versus 0.39 [p = 0.030]). The incidence of PCO in Group B was higher than Group A(28.2% versus 4.4% (p < 0.001)). There were no complications associated with posterior capsulotomy.
A primary posterior capsulotomy during combined phaco-vitrectomy using a 23-gauge vitreous cutter was a safe and effective surgical procedure in patients with RRD patients for preventing postoperative intraocular lens-related PCO.
通过分析行联合白内障超声乳化吸除术与玻璃体切除术（23G）治疗的孔源性视网膜脱离（RRD）患者的长期视觉预后，评价后囊切开术的疗效和安全性。
对行联合白内障超声乳化吸除术与玻璃体切除术（23G）治疗的 RRD 患者的临床资料进行回顾性纵向队列分析。患者分为两组：A 组（68 眼 68 例）行后囊切开术，B 组（39 眼 39 例）不行后囊切开术。观察最佳矫正视力（BCVA）、后发性白内障（PCO）发生率、RRD 诊断时的临床特征以及后囊切开术的术中或术后并发症。
A 组和 B 组患者在初始诊断、术后 3、6、12 个月时的改良 LogMAR BCVA 分别为 0.67 和 0.85（p = 0.258）、0.40 和 0.50（p = 0.309）、0.27 和 0.45（p = 0.055）、0.21 和 0.47（p = 0.014）。在黄斑区受累的 RRD 亚组中，A 组在术后 6 个月（0.17 对 0.40，p = 0.037）和 12 个月（0.14 对 0.39，p = 0.030）的视力优于 B 组。B 组的 PCO 发生率高于 A 组（28.2%对 4.4%，p < 0.001）。后囊切开术无相关并发症。
在 23G 玻璃体切除术中行原发性后囊切开术是一种安全有效的手术方法，可预防术后人工晶状体相关性 PCO。
