Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan.
Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Jpn J Ophthalmol. 2020 Jul;64(4):359-366. doi: 10.1007/s10384-020-00737-0. Epub 2020 Mar 21.
To evaluate the impact of vitrectomy and air tamponade on aspheric intraocular lens (IOL) tilt and decentration and postoperative internal higher-order aberrations (HOAs) in combined cataract surgery and vitrectomy (phacovitrectomy).
Prospective comparative observational study.
Forty-five eyes that underwent phacovitrectomy using aspheric IOLs and 18 eyes that only underwent cataract surgery also using aspheric IOLs were prospectively evaluated. The subjects were divided into three groups: phacovitrectomy without fluid-air exchange (F/Ax) or with F/Ax and cataract surgery alone (Groups A, B, and C, respectively) Surgery-induced changes in lens tilt and decentration and internal HOAs were compared between each pair of groups. Subgroup analysis was conducted for cases with largely tilted (> 7°) or decentered (> 0.40 mm) IOLs 1 month postoperatively.
Surgery-induced changes in lens tilt in Group B were significantly more pronounced than those in Group C at 1 week, 1 month, and 3 months postoperatively (P = 0.007, 0.009, and 0.043, respectively), while there was no significant difference in surgery-induced changes in lens decentration among the groups. IOLs in Group B were tilted and decentered toward the inferonasal direction. In contrast, there was no significant difference in internal HOAs among the groups at any postoperative visit. Only Group B included cases with largely decentered IOLs, and the internal total HOAs in these cases were significantly larger than those in the others (P = 0.015).
Although largely decentered IOLs were occasionally found in Group B, aspheric IOLs could be effectively used in phacovitrectomy.
评估白内障玻璃体切除手术中玻璃体切除和空气填充对非球面人工晶状体（IOL）倾斜和偏心以及术后内部高阶像差（HOA）的影响。
前瞻性对照观察研究。
前瞻性评估了 45 只接受白内障玻璃体切除手术联合非球面 IOL 的眼和 18 只仅接受白内障手术联合非球面 IOL 的眼。这些患者被分为三组：不进行或进行液气交换的白内障玻璃体切除手术（分别为 A、B 和 C 组）。比较每组之间的手术引起的晶状体倾斜和偏心以及内部 HOA 的变化。对术后 1 个月有明显倾斜（>7°）或偏心（>0.40mm）的 IOL 进行亚组分析。
术后 1 周、1 个月和 3 个月，B 组晶状体倾斜的手术诱导变化明显大于 C 组（P=0.007、0.009 和 0.043），而晶状体偏心的手术诱导变化在各组之间无显著差异。B 组的 IOL 向鼻下方向倾斜和偏心。相反，各组在任何术后随访中内部 HOA 均无显著差异。只有 B 组包括明显偏心的 IOL 病例，这些病例的总内部 HOA 明显大于其他病例（P=0.015）。
尽管 B 组偶尔会发现明显偏心的 IOL，但非球面 IOL 可有效地用于白内障玻璃体切除手术。
