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接受玻璃体切割术患者的前房型人工晶状体植入术的结果

Outcomes of Anterior Chamber Intraocular Lens Implantation in Patients Undergoing Pars Plana Vitrectomy.

作者信息

Finn Avni P, Feng Henry L, Kim Terry, Mahmoud Tamer H

机构信息

Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.

Department of Ophthalmology, Associated Retina Consultants, Royal Oak, Michigan.

出版信息

Ophthalmol Retina. 2018 Sep;2(9):895-899. doi: 10.1016/j.oret.2018.02.006. Epub 2018 Mar 27.

DOI:10.1016/j.oret.2018.02.006
PMID:31047221
Abstract

PURPOSE

To assess outcomes and complication rates in patients undergoing pars plana vitrectomy (PPV) and implantation of an anterior chamber intraocular lens (ACIOL).

DESIGN

Retrospective chart review.

PARTICIPANTS

A total of 50 eyes that underwent secondary ACIOL placement in the setting of concurrent PPV from October 2000 to August 2016 were included.

METHODS

A retrospective chart review was conducted.

MAIN OUTCOME MEASURES

The primary outcome measure was the occurrence of postoperative complication including persistently elevated intraocular pressure, persistent or recurrent hyphema, persistent or recurrent vitreous hemorrhage, persistent corneal edema, or persistent uveitis, macular edema, epiretinal membrane, lens dislocation, retinal tear, or retinal detachment. The secondary outcome measure was best-corrected visual acuity (BCVA).

RESULTS

Postoperative complications occurred as follows: persistently elevated intraocular pressure in 4 eyes (8%), persistent corneal edema in 1 eye (2%), persistent postoperative uveitis in 1 eye (2%). Seven eyes (14%) had new macular edema and 2 eyes (4%) had new epiretinal membranes after combined PPV and ACIOL surgery. No patient had persistent postoperative hyphema, vitreous hemorrhage, retinal tear, retinal detachment, or lens dislocation after ACIOL placement. Mean preoperative BCVA was 20/200 (logarithm of the minimum angle of resolution 0.96) and improved to 20/40 (logarithm of the minimum angle of resolution 0.28, P ≤ 0.0001) at 1 year postoperatively.

CONCLUSIONS

Whereas there is a recent emphasis on new intraocular lens placement techniques in the setting of PPV including sutured and scleral-fixated intraocular lenses, ACIOL placement in the setting of concurrent PPV is a safe procedure, with few eyes developing long-term complications if careful case selection is employed.

摘要

目的

评估接受玻璃体切割术(PPV)联合前房人工晶状体(ACIOL)植入术患者的手术效果及并发症发生率。

设计

回顾性病历分析。

研究对象

纳入2000年10月至2016年8月期间50例在同期PPV情况下接受二期ACIOL植入术的患眼。

方法

进行回顾性病历分析。

主要观察指标

主要观察指标为术后并发症的发生情况,包括持续性眼压升高、持续性或复发性前房积血、持续性或复发性玻璃体积血、持续性角膜水肿、持续性葡萄膜炎、黄斑水肿、视网膜前膜、晶状体脱位、视网膜裂孔或视网膜脱离。次要观察指标为最佳矫正视力(BCVA)。

结果

术后并发症发生情况如下:4例(8%)出现持续性眼压升高,1例(2%)出现持续性角膜水肿,1例(2%)出现持续性术后葡萄膜炎。PPV联合ACIOL手术后7例(14%)出现新的黄斑水肿,2例(4%)出现新的视网膜前膜。ACIOL植入术后无患者出现持续性术后前房积血、玻璃体积血、视网膜裂孔、视网膜脱离或晶状体脱位。术前平均BCVA为20/200(最小分辨角对数0.96),术后1年提高至20/40(最小分辨角对数0.28,P≤0.0001)。

结论

尽管近期对于PPV情况下新型人工晶状体植入技术如缝线固定和巩膜固定人工晶状体较为关注,但在同期PPV情况下植入ACIOL是一种安全的手术方法,若仔细选择病例,很少有患眼出现长期并发症。

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