Devireddy Nitya, Borkhetaria Rucha, Cannon Nathan, Bowie Esther, Pantanelli Seth M
Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA.
Clin Ophthalmol. 2024 May 7;18:1225-1233. doi: 10.2147/OPTH.S457416. eCollection 2024.
To investigate refractive, visual, and safety outcomes of cataract surgery performed after scleral buckling (SB) for retinal detachment (RD).
A chart review at an academic medical center identified eyes with history of SB followed by subsequent cataract extraction between 2010 and 2022. Eyes with less than 3 weeks follow-up, silicone oil at time of biometry measurement, previous cornea surgery, or co-existing pathology impacting refractive outcomes were excluded. Predicted postoperative spherical equivalents (SE) were calculated with the Barrett Universal II (BU2), Kane, and SRK/T formulas for the implanted intraocular lens (IOL), and complications occurring within 1 year of surgery were abstracted.
Sixty eyes of 60 patients met criteria for inclusion, and 40 (66.7%) had postoperative refraction recorded. Absolute prediction errors were 0.49, 0.45, and 0.52D with BU2, Kane, and SRK/T, respectively. Actual postoperative refraction was within 0.5 and 1.0 D of predicted in 26 (65.0%) and 36 (90.0%) using BU2, 23 (58%) and 37 (93%) using Kane, and 21 (52.5%) and 36 (90.0%) using SRK/T. In eyes with macula-on RD, corrected distance visual acuity (CDVA) of logMAR 0.301 (≈20/40) and logMAR 0.544 (≈20/70) or better was achieved in 12 (75.0%) and 15 (93.8%) of eyes. For macula-off RD eyes, these proportions were 19 (63.3%) and 24 (80.0%), respectively. Posterior capsular opacification requiring Nd: YAG capsulotomy was the most frequent complication in 30 (56.7%) eyes.
Refractive outcomes of cataract surgery following SB may be modestly reduced, even when using modern formulas. Nevertheless, cataract surgery in this population results in favorable visual outcomes.
研究巩膜扣带术（SB）治疗视网膜脱离（RD）后白内障手术的屈光、视觉和安全性结果。
在一家学术医疗中心进行病历回顾，确定2010年至2022年间有SB病史且随后接受白内障摘除术的眼睛。排除随访时间少于3周、生物测量时存在硅油、既往有角膜手术史或存在影响屈光结果的并存病变的眼睛。使用巴雷特通用II（BU2）、凯恩和SRK/T公式计算植入人工晶状体（IOL）的预测术后球镜等效度（SE），并提取手术1年内发生的并发症。
60例患者的60只眼符合纳入标准，40只眼（66.7%）记录了术后屈光情况。使用BU2、凯恩和SRK/T公式时，绝对预测误差分别为0.49D、0.45D和0.52D。使用BU2时，26只眼（65.0%）和36只眼（90.0%）的实际术后屈光在预测值的0.5D和1.0D范围内；使用凯恩时，分别为23只眼（58%）和37只眼（93%）；使用SRK/T时，分别为21只眼（52.5%）和36只眼（90.0%）。在黄斑在位的RD眼中，12只眼（75.0%）和15只眼（93.8%）的矫正远视力（CDVA）达到logMAR 0.301（≈20/40）和logMAR 0.544（≈20/70）或更好。对于黄斑脱离的RD眼，这些比例分别为19只眼（63.3%）和24只眼（80.0%）。需要钕:钇铝石榴石囊切开术的后囊膜混浊是最常见的并发症，发生在30只眼（56.7%）。
即使使用现代公式，SB后白内障手术的屈光结果可能会略有降低。然而，该人群的白内障手术仍能带来良好的视觉效果。
