Kataria Aman S, Thompson John T
Johns Hopkins University School of Public Health, Baltimore, Maryland.
Retina Specialists, Greater Baltimore Medical Center, Towson, Maryland.
Ophthalmol Retina. 2017 Mar-Apr;1(2):149-153. doi: 10.1016/j.oret.2016.09.007. Epub 2016 Nov 23.
To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking cataracts in nondiabetic patients <50 years of age after a pars plana vitrectomy.
Retrospective cohort study.
Twenty-six eyes of 26 patients <50 years of age that had undergone a pars plana vitrectomy were included.
Clinical records were reviewed retrospectively.
The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from care, lost to follow-up, or last visit before cataract surgery. Eyes were graded on a scale of 0 to 4.0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular hole, epiretinal membranes, and vitreous hemorrhage. Linear regression analysis was performed to evaluate the rate of change in cataract score with elapsed time since surgery.
The mean age at surgery was 30.6±14.3 years in 26 eyes with a median follow-up of 12 months. Eleven of 26 surgical eyes (42.3%) that had a baseline NSC and PSC score of zero in their surgical eye developed NSC, PSC, or both after vitrectomy. The mean progression for NSC, PSC, and cortical spoking were 0.327±0.14 (P = 0.032), 0.414±0.14 (P = 0.008), and 0.00±0.00 over a mean follow-up of 1.43 years, respectively. Linear regression analysis shows minimal increase in NSC (+0.09/year; P < 0.001; R = +0.331), a slight increase in PSC (+0.16/year; P < 0.001; R = +0.835), and a minimal decrease in cortical spoking (-0.02/year; P < 0.05; R = -0.09).
Our findings suggest there is a minimal but significant increase in NSC and PSC scores for patients <50 years after pars plana vitrectomy. Cataract progression is not a significant factor in the first few years after vitrectomy in patients <50 years of age.
测量年龄小于50岁的非糖尿病患者行玻璃体切割术后核性硬化性白内障（NSC）、后囊下白内障（PSC）和皮质辐轮状白内障的发生及进展速率。
回顾性队列研究。
纳入26例年龄小于50岁且接受过玻璃体切割术的患者的26只眼。
对临床记录进行回顾性分析。
术前及术后1、3、6、9和12个月记录NSC、PSC和皮质辐轮状白内障评分，直至出院、失访或白内障手术前的最后一次就诊。在玻璃体切割术前及术后，使用晶状体混浊分级系统（LOCS II）对黄斑裂孔、视网膜前膜和玻璃体积血的眼睛进行0至4.0级评分。进行线性回归分析以评估白内障评分随术后时间的变化率。
26只眼的平均手术年龄为30.6±14.3岁，中位随访时间为12个月。26只手术眼中，手术眼基线NSC和PSC评分为零的11只眼（42.3%）在玻璃体切割术后出现了NSC、PSC或两者皆有。在平均1.43年的随访中，NSC、PSC和皮质辐轮状白内障的平均进展分别为0.327±0.14（P = 0.032）、0.414±0.14（P = 0.008）和0.00±0.00。线性回归分析显示，NSC有最小但显著的增加（+0.09/年；P < 0.001；R = +0.331），PSC有轻微增加（+0.16/年；P < 0.001；R = +0.835），皮质辐轮状白内障有最小程度的降低（-0.02/年；P < 0.05；R = -0.09）。
我们的研究结果表明，年龄小于50岁的患者行玻璃体切割术后，NSC和PSC评分有最小但显著的增加。在年龄小于50岁的患者中，白内障进展在玻璃体切割术后的头几年不是一个重要因素。
