Department of Ophthalmology, Gil Medical Center, College of Medicine, Gachon University, 21 Namdong-daero 774-beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea.
BMC Ophthalmol. 2023 May 26;23(1):236. doi: 10.1186/s12886-023-02982-6.
To compare the intraoperative challenges, complications, and operation time of illuminated chopper-assisted cataract surgery between cataract surgery only and phacovitrectomy in eyes with diabetic retinopathy.
One university hospital, retrospective case series. Two hundred ninety-five eyes of 295 consecutive patients with diabetic retinopathy who underwent cataract surgery only or phacovitrectomy were retrospectively reviewed. Intraoperative challenges and complications of cataract surgery were thoroughly analyzed by 3D viewing of digitally recorded videos. The pupil diameter, operation time, and improved efficacy (100/operation time × pupil diameter) were compared between the cataract surgery only and phacovitrectomy groups.
Of the 295 eyes, 211 underwent cataract surgery only, and 84 underwent phacovitrectomy. Intraoperative challenges such as small pupil, miosis, or poor red reflex occurred more frequently (46 [21.8%] vs. 28 [33.3%], p = 0.029); pupil diameter was smaller (7.34 ± 0.94 vs. 6.89 ± 0.88 mm, p < 0.001) in the phacovitrectomy group than in the cataract surgery only group; however, rates of posterior capsule rupture and operation time were not different between the two groups (0 [0%] vs. 1 [1.2%], p = 0.285; 16.54 ± 2.65 vs. 16.31 ± 4.30 min, p = 0.434). Improved efficacy was higher in the phacovitrectomy group (0.85 ± 0.18 vs. 0.97 ± 0.28, p = 0.002).
The use of an illuminated chopper is a potential solution for diabetic cataract surgery, particularly in phacovitrectomy, by decreasing the use of supplemental devices, operation time, and posterior capsule rupture.
Retrospectively registered.
比较糖尿病视网膜病变患者白内障手术中仅行白内障超声乳化术（cataract surgery only）与白内障超声乳化吸除联合玻璃体切除术（phacovitrectomy）的术中挑战、并发症和手术时间。
单中心回顾性病例系列研究。回顾性分析 295 例（295 只眼）连续糖尿病视网膜病变患者的临床资料，其中 211 只眼仅行白内障超声乳化术，84 只眼行白内障超声乳化吸除联合玻璃体切除术。通过数字录像的 3D 观察，对白内障手术中的瞳孔直径、手术时间、手术效率（100/手术时间×瞳孔直径）进行比较。
在 295 只眼中，211 只眼仅行白内障超声乳化术，84 只眼行白内障超声乳化吸除联合玻璃体切除术。术中挑战如小瞳孔、瞳孔缩小或红色反射差等在白内障超声乳化吸除联合玻璃体切除术中更常见（46 [21.8%] 比 28 [33.3%]，p = 0.029）；白内障超声乳化吸除联合玻璃体切除术中的瞳孔直径更小（7.34 ± 0.94 比 6.89 ± 0.88 mm，p < 0.001）；但两组后囊破裂和手术时间无差异（0 [0%] 比 1 [1.2%]，p = 0.285；16.54 ± 2.65 比 16.31 ± 4.30 min，p = 0.434）。白内障超声乳化吸除联合玻璃体切除术中手术效率更高（0.85 ± 0.18 比 0.97 ± 0.28，p = 0.002）。
在糖尿病性白内障手术中，使用带照明的超声乳化刀可以减少辅助设备的使用、手术时间和后囊破裂的发生，是一种潜在的解决方案，尤其是在白内障超声乳化吸除联合玻璃体切除术中。
回顾性注册。
