玻璃体内同时与序贯施行玻璃体切除术与白内障手术的比较。

Comparison of simultaneous vs sequential pars plana vitrectomy and cataract surgery.

机构信息

Cornea, Cataract and Anterior Segment Division, The Wilmer Eye Institute, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 600 N Wolfe Street, Maumenee 327, Baltimore, MD, 21287, USA.

出版信息

BMC Ophthalmol. 2023 Feb 23;23(1):74. doi: 10.1186/s12886-023-02801-y.

DOI:10.1186/s12886-023-02801-y

PMID:36823593

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9948424/

Abstract

BACKGROUND

To compare the clinical outcomes of patients undergoing sequential pars plana vitrectomy (PPV) followed by cataract extraction surgery (CE) [PPV/CE], simultaneous PPV and CE (PPV + CE), and sequential CE followed by PPV [CE/PPV].

METHODS

A retrospective observational cohort study of 427 eyes of 404 patients who underwent either sequential or simultaneous PPV and CE surgery between March 2016 and May 2021. Pre-operative and post-operative assessments (up to 2 years of follow-up visits) of uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), spherical equivalent (SEQ), and refractive prediction error (RPE) was done. Main outcome measures were both visual (UCVA, CDVA) and refractive (RPE, SEQ).

RESULTS

There was a statistically significant difference in CDVA of the PPV/CE, PPV + CE, CE/PPV groups (logMAR 0.34 ± 0.40, 0.65 ± 0.61, and 0.55 ± 0.60, respectively) at one month postoperatively (POM1) (P < 0.001), and at the POM12 visits (logMAR 0.25 ± 0.34, 0.53 ± 0.68, and 0.44 ± 0.48; P = 0.04). In the subgroup analysis of patients with a diagnosis of either epiretinal membrane or vitreous opacities, there was no statistically significant difference in SEQ (P = 0.09) and RPE (P = 0.13) at the combined 1 month and 3 month visits.

CONCLUSION

Simultaneous PPV and cataract surgery demonstrated similar improvements in visual acuity and refractive outcomes, as well as comparable intraoperative and postoperative complication profiles to sequential surgery.

摘要

背景

比较行序贯玻璃体切除术（PPV）继以白内障摘出术（CE）[PPV/CE]、同期 PPV 与 CE（PPV+CE）和序贯 CE 继以 PPV[CE/PPV]的患者的临床结局。

方法

对 2016 年 3 月至 2021 年 5 月间行序贯或同期 PPV 与 CE 手术的 404 例 427 只眼的回顾性观察性队列研究。对未经矫正的视力（UCVA）、矫正距离视力（CDVA）、球镜等效（SEQ）和屈光预测误差（RPE）进行术前和术后评估（随访访视时间最长达 2 年）。主要观察指标是视力（UCVA、CDVA）和屈光（RPE、SEQ）。

结果

在术后 1 个月（POM1）（P<0.001）和术后 12 个月（POM12）（logMAR 0.25±0.34、0.53±0.68 和 0.44±0.48），PPV/CE、PPV+CE 和 CE/PPV 组的 CDVA 存在统计学差异（logMAR 0.34±0.40、0.65±0.61 和 0.55±0.60）。在视网膜前膜或玻璃体混浊的患者亚组分析中，在联合 1 个月和 3 个月访视时，SEQ（P=0.09）和 RPE（P=0.13）无统计学差异。