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常规白内障手术后晶状体脱位的危险因素:病例对照研究。

Risk factors of intraocular lens dislocation following routine cataract surgery: a case-control study.

机构信息

Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.

NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.

出版信息

Clin Exp Optom. 2021 May;104(4):510-517. doi: 10.1080/08164622.2021.1878829. Epub 2021 Feb 10.

Abstract

: Intraocular lens dislocation usually causes severe visual symptoms and even blindness in patients. It is important for eye care practitioners to be able to identify patients susceptible to intraocular lens dislocation.: To investigate the risk factors of intraocular lens dislocation following routine cataract surgery.: This retrospective case-control study included patients diagnosed with intraocular lens dislocation between January 2007 and March 2018. Controls matched to the cases by age and time of routine cataract surgery in a ratio of 3:1 were randomly selected from patients without intraocular lens dislocation. The medical records of the patients were reviewed and analysed. Independent -test, chi-square test, and logistic regression analysis were employed to identify risk factors of intraocular lens dislocation.: In total, 127 cases (with intraocular lens dislocation) and 381 controls (without intraocular lens dislocation) were evaluated. Among cases, the proportion of men was significantly higher than that of women (p = 0.012). High myopia was significantly associated with all types of intraocular lens dislocation; it was also a risk factor for in-the-bag intraocular lens dislocation. Lens subluxation was significantly associated with the in-the-bag and late intraocular lens dislocations. Intraoperative and post-operative vitrectomy, rather than pre-operative vitrectomy, were associated with intraocular lens dislocation. Post-operative trauma was significantly associated with in-the-bag intraocular lens dislocation; pre-operative and post-operative trauma were significantly associated with out-of-the-bag intraocular lens dislocation. Male sex (odds ratio (OR) = 2.996, p = 0.006), pre-operative trauma (OR = 7.861, p = 0.014), high myopia (OR = 11.268, p < 0.001), and lens subluxation (OR = 13.431, p = 0.018) were the risk factors of intraocular lens dislocation.: Male sex, pre-operative trauma, high myopia, and lens subluxation were the main predisposing factors for intraocular lens dislocation in Chinese Han population.

摘要

: 人工晶状体脱位通常会导致患者出现严重的视力症状,甚至失明。眼科医生能够识别出易发生人工晶状体脱位的患者非常重要。: 探讨常规白内障手术后人工晶状体脱位的危险因素。: 这项回顾性病例对照研究纳入了 2007 年 1 月至 2018 年 3 月期间诊断为人工晶状体脱位的患者。将与病例年龄和常规白内障手术时间相匹配的、未发生人工晶状体脱位的患者按 3:1 的比例随机抽取作为对照组。回顾性分析患者的病历资料。采用独立样本 t 检验、卡方检验和 logistic 回归分析来识别人工晶状体脱位的危险因素。: 共评估了 127 例(发生人工晶状体脱位)和 381 例(未发生人工晶状体脱位)患者。病例组中男性比例明显高于女性(p=0.012)。高度近视与所有类型的人工晶状体脱位均显著相关,是囊袋内人工晶状体脱位的危险因素。晶状体半脱位与囊袋内和迟发性人工晶状体脱位显著相关。术中及术后玻璃体切割术而非术前玻璃体切割术与人工晶状体脱位相关。术后创伤与囊袋内人工晶状体脱位显著相关,术前和术后创伤与囊外人工晶状体脱位显著相关。男性(比值比(OR)=2.996,p=0.006)、术前创伤(OR=7.861,p=0.014)、高度近视(OR=11.268,p<0.001)和晶状体半脱位(OR=13.431,p=0.018)是人工晶状体脱位的危险因素。: 男性、术前创伤、高度近视和晶状体半脱位是中国汉族人群发生人工晶状体脱位的主要易感因素。

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