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白内障手术后晶状体碎片残留的玻璃体切除术:基于手术时机的结果

Pars Plana Vitrectomy for Retained Lens Fragments After Cataract Surgery: Outcomes Based on Timing of Surgery.

作者信息

Rohowetz Landon J, Jabbehdari Sayena, Yannuzzi Nicolas A, Sridhar Jayanth, Smiddy William E, Berrocal Audina M, Albini Thomas A, Townsend Justin H, Fortun Jorge A, Flynn Harry W

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA.

Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

出版信息

Clin Ophthalmol. 2023 Feb 1;17:479-485. doi: 10.2147/OPTH.S391795. eCollection 2023.

Abstract

PURPOSE

To evaluate the outcomes and complications in patients with retained lens fragments (RLF) after cataract surgery, comparing those who received pars plana vitrectomy (PPV) on the same day, within 1 week, or later than 1 week after cataract surgery.

PATIENTS AND METHODS

Retrospective case series of all patients who underwent PPV for RLF at Bascom Palmer Eye Institute between January 1, 2012 and September 30, 2020. Individuals with less than 3 months of follow-up, chronic uveitis, congenital cataract, previtrectomy retinal detachment (RD), and severe trauma were excluded. All analyses for categorical and binary variables used chi-squared tests. Analyses for continuous variables were performed using multivariate analyses of covariance, adjusting for differences in baseline visual acuity before cataract surgery.

RESULTS

The study included 246 eyes of 246 patients. The timing distribution included the following: 140 (57%) eyes underwent same-day PPV, 33 (13%) eyes underwent same-week PPV, and 73 (30%) eyes underwent PPV after 1 week (up to 90 days). When all eyes were included in analysis, there were no statistically significant differences in mean best-corrected visual acuity (BCVA) between groups at last follow-up examination ( = 0.07). When only eyes without known pre-existing ocular disease (N = 157) were included in analysis, there were no differences in mean BCVA between groups at all postoperative timepoints ( > 0.05). The rate of RD did not differ between groups when eyes with and without pre-existing ocular disease were analyzed ( > 0.05).

CONCLUSION

In the current study, there were no statistically significant differences in postoperative BCVA or rates of RD at last follow-up examination in eyes undergoing PPV for RLF on the same day, within 1 week, or later than 1 week after cataract surgery.

摘要

目的

评估白内障手术后晶状体碎片残留(RLF)患者的治疗效果及并发症,比较在白内障手术后当天、1周内或1周后接受玻璃体切割术(PPV)的患者情况。

患者与方法

对2012年1月1日至2020年9月30日期间在巴斯科姆·帕尔默眼科研究所因RLF接受PPV的所有患者进行回顾性病例系列研究。排除随访时间少于3个月、慢性葡萄膜炎、先天性白内障、玻璃体切割术前视网膜脱离(RD)和严重外伤的患者。对分类变量和二元变量的所有分析均采用卡方检验。对连续变量的分析采用多变量协方差分析,并对白内障手术前的基线视力差异进行校正。

结果

该研究纳入了246例患者的246只眼。时间分布如下:140只眼(57%)在当天接受PPV,33只眼(13%)在同一周内接受PPV,73只眼(30%)在1周后(最长90天)接受PPV。当所有眼睛纳入分析时,在最后一次随访检查时,各组之间的平均最佳矫正视力(BCVA)无统计学显著差异(P = 0.07)。当仅纳入无已知既往眼部疾病的眼睛(N = 157)进行分析时,在所有术后时间点,各组之间的平均BCVA无差异(P>0.05)。在分析有或无既往眼部疾病的眼睛时,各组之间的RD发生率无差异(P>0.05)。

结论

在本研究中,白内障手术后当天、1周内或1周后因RLF接受PPV的眼睛,在最后一次随访检查时,术后BCVA或RD发生率无统计学显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d03e/9899933/3351a16109e1/OPTH-17-479-g0001.jpg

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