Chen Xu, Zhao He, Ren Jia-Yun, Wang Lu, Wan Jun-Li, Liu Bo, Wu Nan, Liu Xi, Liu Yong
Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing 400038, China.
Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China.
Int J Ophthalmol. 2023 Apr 18;16(4):554-562. doi: 10.18240/ijo.2023.04.09. eCollection 2023.
To evaluate the postoperative refractive prediction error (PE) and determine the factors that affect the refractive outcomes of combined pars plana vitrectomy (PPV) or silicone oil removal (SOR) with cataract surgery.
The study is a retrospective, case-series study. Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled. Eligible individuals were separated into four groups according to their preoperative diagnoses: silicone oil-filled eyes after PPV (group 1), epiretinal membrane (group 2), macular hole (group 3), and primary retinal detachment (RD; group 4). The variables affecting postoperative refractive outcomes were analyzed, including age, gender, preoperative best-corrected visual acuity (BCVA), axial length (AL), keratometry average, anterior chamber depth (ACD), intraocular tamponade, and vitreoretinal pathology. The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within ±0.50 diopter (D) and ±1.00 D.
For all patients, the mean PE was -0.04±1.17 D, and 50.17% of patients (eyes) had a PE within ±0.50 D. There was a significant difference in refractive outcomes among the four groups (=0.028), with RD (group 4) showing the least favorable refractive outcome. In multivariate regression analysis, only AL, vitreoretinal pathology, and ACD were strongly associated with PE (all <0.01). Univariate analysis revealed that longer eyes (AL>26 mm) and a deeper ACD were correlated with hyperopic PE, and shorter eyes (AL<26 mm) and a shallower ACD were correlated with myopic PE.
RD patients have the least favorable refractive outcome. AL, vitreoretinal pathology, and ACD are strongly associated with PE in the combined surgery. These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.
评估白内障手术联合玻璃体切割术（PPV）或硅油取出术（SOR）后的屈光预测误差（PE），并确定影响屈光结果的因素。
本研究为回顾性病例系列研究。共纳入301例接受PPV/SOR联合白内障手术患者的301只眼。符合条件的个体根据术前诊断分为四组：PPV术后硅油填充眼（第1组）、视网膜前膜（第2组）、黄斑裂孔（第3组）和原发性视网膜脱离（RD；第4组）。分析影响术后屈光结果的变量，包括年龄、性别、术前最佳矫正视力（BCVA）、眼轴长度（AL）、平均角膜曲率、前房深度（ACD）、眼内填充物及玻璃体视网膜病变。结果测量包括平均屈光PE以及PE在±0.50屈光度（D）和±1.00 D范围内的眼的比例。
所有患者的平均PE为-0.04±1.17 D，50.17%的患者（眼）PE在±0.50 D范围内。四组之间的屈光结果有显著差异（=0.028），RD（第4组）的屈光结果最不理想。在多因素回归分析中，只有AL、玻璃体视网膜病变和ACD与PE密切相关（均<0.01）。单因素分析显示，眼轴较长（AL>26 mm）和ACD较深与远视性PE相关，眼轴较短（AL<26 mm）和ACD较浅与近视性PE相关。
RD患者的屈光结果最不理想。在联合手术中，AL、玻璃体视网膜病变和ACD与PE密切相关。这三个因素影响屈光结果，因此在临床实践中可用于预测更好的术后屈光结果。
