Int Ophthalmol Clin. 2022 Jul 1;62(3):65-77. doi: 10.1097/IIO.0000000000000423. Epub 2022 Jun 22.
: The purpose of this article is to discuss the early- and late-onset corneal complications that can occur following vitreoretinal surgery.
: A systematic review of the literature was conducted using PubMed and Google Scholar databases. Articles detailing the clinical findings and the associations between surgical techniques, irrigating solutions, and microsurgical instruments used for vitreoretinal surgery and postoperative corneal complications were included in this review.
: Vitreoretinal surgery can be associated with corneal complications such as persistent corneal epithelial defects, neurotrophic keratopathy, band keratopathy, ocular surface disruption, and endothelial cell damage. Risk factors for the development of cornea complications after posterior segment surgery include history of uncontrolled diabetes mellitus, aphakia or pseudophakia, disrupted anterior lens capsule integrity, use of irrigating solutions without appropriate buffers, use of contact viewing lenses intraoperatively, intraocular gases or silicone oil after vitrectomy, and prolonged duration of surgery.
: Corneal complications secondary to vitreoretinal surgery are multifactorial, but more commonly arise in diabetic patients, those with preexisting ocular comorbidities, and under certain surgical-related conditions. Special pre-, peri-, and postoperative considerations, with a focus on early identification and management of risk factors, are required to help decrease the incidence of corneal complications.
本文旨在讨论玻璃体视网膜手术后可能出现的早发和迟发性角膜并发症。
通过使用 PubMed 和 Google Scholar 数据库进行系统的文献回顾。本文纳入了详细描述临床发现以及玻璃体视网膜手术中使用的手术技术、灌洗液和显微手术器械与术后角膜并发症之间的相关性的研究。
玻璃体视网膜手术可引起角膜并发症，如持续性角膜上皮缺损、神经营养性角膜病变、带状角膜病变、眼表破坏和内皮细胞损伤。后节手术发生角膜并发症的危险因素包括未控制的糖尿病史、无晶状体或人工晶状体、前晶状体囊完整性破坏、使用无适当缓冲液的灌洗液、术中使用接触式眼罩、玻璃体切除术后眼内气体或硅油以及手术时间延长。
玻璃体视网膜手术后的角膜并发症是多因素的，但更常见于糖尿病患者、有眼部合并症的患者和某些手术相关情况下。需要特别注意术前、术中和术后的考虑因素，并重点关注危险因素的早期识别和管理，以帮助降低角膜并发症的发生率。
