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激光散射细胞光度测定术在白内障术后炎症评估中的应用:预测黄斑囊样水肿风险的工具。

Laser flare and cell photometry to measure inflammation after cataract surgery: a tool to predict the risk of cystoid macular edema.

机构信息

Ophthalmology Unit, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Viale Risorgimento 80, 42122, Reggio Emilia, Italy.

Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

Int Ophthalmol. 2021 Jun;41(6):2293-2300. doi: 10.1007/s10792-021-01779-0. Epub 2021 Mar 21.

Abstract

PURPOSE

To review the current adoption of laser flare and cell photometry (LFCP) in the setting of modern cataract surgery to analyze inflammation aiming to identify evidence of a correlation between LFCP values and the risk of cystoid macular edema (CME) development.

METHODS

An extensive PubMed literature search was performed to review all the published studies investigating inflammation by LFCP after uncomplicated phacoemulsification. The following keywords were used: cataract surgery, cystoid macular edema, anterior chamber inflammation, laser flare, and cell photometry.

RESULTS

Seventy-eight original articles investigating inflammation by LFCP were selected. Macula alterations were searched in 12 (15%) trials, by optical coherence tomography or fluorescein angiography in 11 (14%) and 1 (1%) studies, respectively. Among them, 9 (12%) papers investigated the correlation between LFCP values and cystic changes to the macula: 7 (9%) and 2 (3%) studies identified a positive and negative correlation, respectively. Three (4%) papers did not perform any correlation analysis.

CONCLUSION

CME, as a consequence of uncontrolled postoperative inflammation, is a common cause for unfavorable visual outcomes following uncomplicated phacoemulsification with IOL implantation. After surgery, intraocular inflammation is generally assessed by qualitative methods. Although well-established and practical in uveitis, they are inadequate to detect the modest inflammatory response that usually occurs after uneventful phacoemulsification. LFCP correlate with the chance of macula alteration after surgery and higher the values higher the risk of CME. The quantitative analysis of intraocular inflammation by LFCP after cataract surgery might be a tool to predict the risk of pseudophakic CME.

摘要

目的

回顾现代白内障手术中激光散射光和细胞光度测定(LFCP)的应用现状,分析炎症情况,以确定 LFCP 值与囊状黄斑水肿(CME)发生风险之间是否存在相关性。

方法

通过广泛的 PubMed 文献检索,对所有关于非复杂性超声乳化白内障吸除术后 LFCP 评估炎症的已发表研究进行综述。使用了以下关键词:白内障手术、囊状黄斑水肿、前房炎症、激光散射光和细胞光度测定。

结果

共选择了 78 篇研究 LFCP 评估炎症的原始文章。12 项(15%)研究通过光学相干断层扫描或荧光素血管造影来研究黄斑变化,11 项(14%)和 1 项(1%)研究分别通过这两种方法来研究黄斑变化。其中,9 项(12%)研究探讨了 LFCP 值与黄斑囊性变化之间的相关性:7 项(9%)研究和 2 项(3%)研究分别发现了正相关和负相关。3 项(4%)研究未进行任何相关性分析。

结论

白内障超声乳化吸除联合人工晶状体植入术后,由于术后炎症控制不佳,导致 CME 是影响视力预后的常见原因。术后,通常通过定性方法评估眼内炎症。虽然在葡萄膜炎中得到了很好的应用和实践,但这些方法不足以检测到通常在无并发症的白内障超声乳化吸除术后发生的轻微炎症反应。LFCP 与术后黄斑改变的几率相关,且值越高,CME 的风险越高。白内障手术后通过 LFCP 对眼内炎症进行定量分析可能是预测后发性白内障 CME 风险的一种手段。

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