Department of Ophthalmology, University Hospital Antwerp, Edegem, Belgium.
Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Edegem, Belgium.
PLoS One. 2023 Jan 6;18(1):e0278861. doi: 10.1371/journal.pone.0278861. eCollection 2023.
To determine the incidence of clinically significant pseudophakic cystoid macular edema (CSPME) after phacoemulsification using the 'bag-in-the-lens' lens (BIL) implantation technique and to examine the influence of associated risk factors for clinically significant pseudophakic macular edema (CSPME), both ocular and systemic.
This retrospective study included 2419 first-operated eyes of 2419 adults who underwent phacoemulsification cataract surgery using the BIL implantation technique between January 2013 and December 2018 in the Antwerp University Hospital, Belgium. The significance of several risk factors (age, gender, previous history, intra- and postoperative complications) was examined by extraction of electronic medical files.
The 3-month incidence of CSPME in the subgroup without risk factors was 0.00% (95% CI: 0.00 -NA). The 3-month incidence of CSPME in the subgroup with risk factors was 0.57% (95% CI 0.22-1.29%). The 3-month incidence of CSPME in the total population of 2419 patients was 0.29% (95% CI: 0.11-0.65%). The risk factors most significantly associated with CSPME included renal insufficiency (hazard ration [HR]: 5.42; 95% CI: 1.69-17.44; P = .014), exudative age-related macular degeneration (HR: 74.50, 95% CI: 25.75-215.6; P < .001) and retinal vein occlusion (HR: 22.48, 95% CI: 4.55-111.02; P = .005).
In the absence of risk factors, the incidence of CSPME was zero. We can conclude that Primary Posterior Continuous Curvilinear Capsulorhexis (PPCCC) does not increase the risk for CSPME. Non-inferiority of the BIL implantation regarding the development of CSPME, relative to the traditional 'lens-in-the-bag' (LIB) implantation, confirms that BIL is a safe surgical technique. This study also illustrates a previously undescribed risk factor for developing CSPME, namely renal insufficiency.
确定使用“囊袋内植入物”（BIL）植入技术行白内障超声乳化术后临床显著的后发性囊下白内障（CSPME）的发生率，并检查与临床显著的后发性白内障（CSPME）相关的眼部和全身相关风险因素的影响。
本回顾性研究纳入了 2013 年 1 月至 2018 年 12 月在比利时安特卫普大学医院接受 BIL 植入技术的 2419 例成年人的 2419 只单眼。通过提取电子病历检查了几个风险因素（年龄、性别、既往史、围手术期并发症）的意义。
无风险因素亚组的 CSPME 3 个月发生率为 0.00%（95%CI：0.00-NA）。有风险因素亚组的 CSPME 3 个月发生率为 0.57%（95%CI：0.22-1.29%）。2419 例患者的 CSPME 3 个月总发生率为 0.29%（95%CI：0.11-0.65%）。与 CSPME 最显著相关的风险因素包括肾功能不全（危险比[HR]：5.42；95%CI：1.69-17.44；P=.014）、渗出性年龄相关性黄斑变性（HR：74.50，95%CI：25.75-215.6；P<.001）和视网膜静脉阻塞（HR：22.48，95%CI：4.55-111.02；P=.005）。
在无风险因素的情况下，CSPME 的发生率为零。我们可以得出结论，原发性后囊连续环形撕囊（PPCCC）不会增加 CSPME 的风险。BIL 植入术相对于传统的“囊袋内植入物”（LIB）植入术在 CSPME 发展方面的非劣效性，证实了 BIL 是一种安全的手术技术。本研究还描述了一个以前未描述的发生 CSPME 的风险因素，即肾功能不全。
