Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Kent Ridge Crescent Singapore, 119260, Singapore, Singapore.
Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Eye (Lond). 2024 Feb;38(2):253-258. doi: 10.1038/s41433-023-02668-9. Epub 2023 Aug 4.
BACKGROUND/ AIMS: To describe the visual outcomes in eyes with dropped nucleus during phacoemulsification surgery.
Singapore National Eye Centre (SNEC).
Retrospective chart review of prospectively reported cases of dropped nucleus.
The clinical charts of all cases of dropped nucleus (Jan 2001 to Dec 2016) were retrospectively reviewed for patient demographics, surgeon type, stage of surgery, timing of pars plana vitrectomy (PPV), and complications. Visual success was defined as best corrected visual acuity (BCVA) ≥ 20/40 at last review. Final risk factors affecting visual success were identified using multivariate logistic regression analysis.
Incidence of dropped nucleus following cataract surgery was 0.17% (n = 292). Duration of follow-up was 25.5 months (mean), 18.5 months (median). There was a statistically significant difference in dropped nucleus rate between Residents (0.3%) and Faculty (0.14%) (x = 38.2, P < 0.001), but ensuing major complications rates were similar. PPV was performed in 251 eyes (87.2%). At final examination, 202 cases (85.2%) achieved BCVA 20/40 or better, after excluding patients with co-existing ocular pathology. Timing of vitrectomy (delayed vs same-day) did not influence the final visual success (x = 0.969, p = 0.51). Risk factors for poor visual outcomes included age >70 years, absence of intraocular lens (IOL) implant, and presence of major complications.
Overall incidence of dropped nucleus in SNEC was 0.17%, with BCVA of 20/40 or better in 85.2% cases. Visual prognosis was influenced by patient's age, presence of IOL implant or additional major complications.
背景/目的：描述白内障超声乳化手术中核下脱位眼的视力结果。
新加坡国家眼科中心（SNEC）。
对核下脱位病例的前瞻性报告进行回顾性图表审查。
回顾性分析 2001 年 1 月至 2016 年 12 月所有核下脱位病例（n=292）的临床病历，记录患者人口统计学、手术医生类型、手术阶段、玻璃体切除术（PPV）时机以及并发症。将末次随访时最佳矫正视力（BCVA）≥20/40 定义为视力成功。使用多变量逻辑回归分析确定影响视力成功的最终危险因素。
白内障手术后核下脱位的发生率为 0.17%（n=292）。随访时间为 25.5 个月（平均），18.5 个月（中位数）。住院医师（0.3%）和教员（0.14%）的核下脱位发生率存在统计学显著差异（x=38.2，P<0.001），但主要并发症发生率相似。251 只眼（87.2%）行玻璃体切除术。末次检查时，排除合并眼部疾病的患者后，202 例（85.2%）获得 20/40 或更好的 BCVA。玻璃体切割术时机（延迟与同日）对最终视力成功无影响（x=0.969，p=0.51）。视力预后不良的危险因素包括年龄>70 岁、无人工晶状体（IOL）植入和存在主要并发症。
SNEC 核下脱位的总发生率为 0.17%，85.2%的病例 BCVA 达到 20/40 或更好。患者年龄、IOL 植入或其他主要并发症的存在影响视力预后。
