Sato Tatsuhiko, Korehisa Haruka, Shibata Shunsuke, Hayashi Ken
Hayashi Eye Hospital, Fukuoka, Japan.
Hayashi Eye Hospital, Fukuoka, Japan.
Ophthalmol Retina. 2020 Jul;4(7):700-707. doi: 10.1016/j.oret.2020.01.022. Epub 2020 Feb 4.
To compare intraocular lens (IOL) dynamics and refractive prediction errors between eyes that underwent phacovitrectomy and eyes that underwent phacoemulsification alone.
Prospective, nonrandomized, comparative, observational study.
Sixty eyes of 60 patients who underwent 25-gauge phacovitrectomy without gas injection for macular pathology and 60 eyes of 60 patients who underwent phacoemulsification alone for cataract were enrolled.
Preoperative optical biometry was performed using the IOLMaster 700 (Carl Zeiss Meditec, Inc, Dublin, CA) to calculate the IOL power with the Barrett Universal II formula. Monofocal, nontoric, single-piece foldable aspherical IOLs were implanted in each patient. Comprehensive ocular examinations, including CASIA2 (Tomey Corp, Nagoya, Japan) evaluations of the preoperative crystalline lens and postoperative IOL positions (i.e., decentration, tilt, and aqueous depth), were performed before and 3 days, 1 month, and 3 months after surgery.
Refractive prediction errors and IOL dynamics.
Mean refractive prediction errors at 3 days, 1 month, and 3 months after phacovitrectomy were 0.51±0.59 diopters (D), 0.11±0.40 D, and 0.05±0.41 D, respectively, whereas those after phacoemulsification alone were 0.43±0.38 D, 0.11±0.37 D, and 0.07±0.34 D, respectively. There was no significant difference in the refractive error between the 2 groups at any time point. A myopic shift of -0.50 D or more negative refractive error occurred in 4 (6.7%) of 60 eyes with phacovitrectomy and 3 (5.0%) of 60 eyes with phacoemulsification alone; there was no significant between-group difference. At 3 months postoperatively, refractive errors within ±0.50 D and ±1.00 D were achieved in 49 (81.7%) and 58 (96.7%) of 60 eyes in the phacovitrectomy group and 52 (86.7%) and 60 (100.0%) of 60 eyes in the phacoemulsification alone group, again without any significant between-group differences. There were no significant differences in the preoperative lens and postoperative IOL positions between the 2 study groups, except for a significantly deeper mean aqueous depth at 3 days after surgery in the phacovitrectomy group.
Neither myopic shift nor IOL displacement occurs after 25-gauge phacovitrectomy with a single-piece IOL without gas injection for macular pathology compared with phacoemulsification alone.
比较接受晶状体玻璃体切除术的眼睛与仅接受超声乳化术的眼睛之间的人工晶状体（IOL）动态变化和屈光预测误差。
前瞻性、非随机、对比、观察性研究。
纳入60例接受25G晶状体玻璃体切除术且未注入气体治疗黄斑病变的患者的60只眼，以及60例仅接受白内障超声乳化术的患者的60只眼。
使用IOLMaster 700（卡尔蔡司医疗技术公司，加利福尼亚州都柏林）进行术前光学生物测量，采用巴雷特通用II公式计算IOL度数。为每位患者植入单焦点、非散光、单片可折叠非球面IOL。在手术前以及手术后3天、1个月和3个月进行全面的眼部检查，包括使用CASIA2（日本名古屋多美公司）评估术前晶状体和术后IOL位置（即偏心、倾斜和前房深度）。
屈光预测误差和IOL动态变化。
晶状体玻璃体切除术后3天、1个月和3个月的平均屈光预测误差分别为0.51±0.59屈光度（D）、0.11±0.40 D和0.05±0.41 D，而仅接受超声乳化术后的平均屈光预测误差分别为0.43±0.38 D、0.11±0.37 D和0.07±0.34 D。两组在任何时间点的屈光误差均无显著差异。60只接受晶状体玻璃体切除术的眼中有4只（6.7%）出现-0.50 D或更大的近视偏移（负屈光误差），60只仅接受超声乳化术的眼中有3只（5.0%）出现这种情况；两组之间无显著差异。术后3个月，晶状体玻璃体切除术组60只眼中有49只（81.7%）的屈光误差在±0.50 D以内，58只（96.7%）在±1.00 D以内；仅接受超声乳化术组60只眼中有52只（86.7%）在±0.50 D以内，60只（100.0%）在±1.00 D以内，两组之间同样无显著差异。两个研究组术前晶状体和术后IOL位置无显著差异，但晶状体玻璃体切除术组术后3天的平均前房深度明显更深。
与仅进行超声乳化术相比，对于黄斑病变采用单片IOL且不注入气体的25G晶状体玻璃体切除术后，既未出现近视偏移，也未发生IOL移位。
