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葡萄膜炎患者白内障手术后的早晚期并发症。

Early and Late Complications after Cataract Surgery in Patients with Uveitis.

机构信息

Department of Ophthalmology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.

Clinic of Ophthalmology, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo.

出版信息

Medicina (Kaunas). 2023 Oct 23;59(10):1877. doi: 10.3390/medicina59101877.

Abstract

: Uveitis, a prevalent eye disorder characterized by inflammatory processes, often leads to cataract formation and significant visual impairment. This study aimed to evaluate preoperative conditions and postoperative outcomes following cataract surgery in uveitis patients. : A retrospective study was conducted at the University Hospital Center Rebro Zagreb, Croatia, involving uveitis patients who underwent cataract surgery between 2013 and 2022. Eligible patients had uveitic cataracts affecting visual acuity or posterior segment visualization in a "quiet eye" and were disease-inactive for at least three months. Patients with certain pre-existing ocular conditions were excluded. The data collected included patient demographics, uveitis type, preoperative therapy, preexisting lesions, and postoperative outcomes such as visual acuity, intraocular pressure, central macular thickness, and complications. Statistical analysis was performed to identify risk factors associated with complications. This study included 105 patients. The most common uveitis types were idiopathic uveitis, HLA-B27-associated uveitis, and JIA uveitis. After cataract surgery, there was a significant improvement in visual acuity at various time points, with 90% of eyes showing improvement. Intraocular pressure decreased over time. Central macular thickness increased at three months post-surgery but remained stable thereafter. Early and late complications were observed in 52.4% and 63.8% of eyes, respectively. The most common complications were posterior capsular opacification (53.3%), macular edema (26.6%), and epiretinal membrane formation (9.52%). The factors associated with complications varied between early and late stages but included age, age at the onset of uveitis, and the uveitis type. In patients with quiescent uveitis undergoing cataract surgery, significant visual improvement was achieved. This study highlights the importance of careful patient selection, preoperative and postoperative inflammation management, and precise surgical techniques. Although complications were common, the risk of capsular opacification, macular edema, and epiretinal membrane formation after surgery increased. However, future investigations should address this study's limitations and further refine perioperative strategies.

摘要

葡萄膜炎是一种常见的眼部疾病,其特征为炎症过程,常导致白内障形成和严重的视力损害。本研究旨在评估葡萄膜炎患者白内障手术后的术前状况和术后结果。

该研究是在克罗地亚萨格勒布雷布罗大学医院中心进行的回顾性研究,纳入了 2013 年至 2022 年间接受白内障手术的葡萄膜炎患者。符合条件的患者患有影响视力或后节可见度的葡萄膜炎性白内障,并且在“安静的眼睛”中至少有三个月无疾病活动。排除了有某些预先存在的眼部疾病的患者。收集的数据包括患者的人口统计学资料、葡萄膜炎类型、术前治疗、预先存在的病变以及术后视力、眼内压、中央黄斑厚度和并发症等结果。进行了统计分析以确定与并发症相关的危险因素。

该研究纳入了 105 例患者。最常见的葡萄膜炎类型是特发性葡萄膜炎、HLA-B27 相关葡萄膜炎和 JIA 葡萄膜炎。白内障手术后,不同时间点的视力均有显著改善,90%的眼视力改善。眼内压随时间下降。术后三个月中央黄斑厚度增加,但此后保持稳定。早期和晚期并发症分别在 52.4%和 63.8%的眼中观察到。最常见的并发症是后囊混浊(53.3%)、黄斑水肿(26.6%)和视网膜前膜形成(9.52%)。与并发症相关的因素在早期和晚期有所不同,但包括年龄、葡萄膜炎发病年龄和葡萄膜炎类型。

在静止性葡萄膜炎患者中进行白内障手术可显著改善视力。本研究强调了仔细选择患者、术前和术后炎症管理以及精确手术技术的重要性。尽管并发症很常见,但手术后囊膜混浊、黄斑水肿和视网膜前膜形成的风险增加。然而,未来的研究应解决本研究的局限性,并进一步完善围手术期策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a14/10608233/fef41478a560/medicina-59-01877-g001.jpg

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