Department of Ophthalmology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi, India.
Middle East Afr J Ophthalmol. 2024 Jun 14;30(2):68-71. doi: 10.4103/meajo.meajo_176_21. eCollection 2023 Apr-Jun.
The purpose of the study was to study the relationship between the timing of pars plana vitrectomy (PPV) with corrected distance visual acuity (CDVA) in cases of nucleus drop during phacoemulsification.
This retrospective analysis included 83 patients, who underwent PPV for nucleus or nuclear fragment drop from July 2017 to November 2019. Timing of PPV (≤2 weeks and >2 weeks) after the primary cataract surgery was noted. The primary endpoint was CDVA at 1 month, which was compared with the time of PPV. Visual outcome was assessed as good if CDVA was better than or equal to 20/40 and poor if CDVA was worse than 20/40. Mode of management along with type of secondary intraocular lens (IOL) implanted was also evaluated.
Out of the 83 cases (55 males and 28 females) in which vitrectomy for nucleus drop was performed, 36 cases were operated within 2 weeks and 47 were operated between 2 weeks and 1 month. In cases which were operated within 2 weeks, CDVA of 20/20-20/40 was achieved in 33 cases. For those who were operated on after 2 weeks, CDVA of 20/20-20/40 was achieved in 43 cases. The difference in visual outcome in both the groups was statistically nonsignificant (Fisher's exact -test, = 0.97). In 64 (77%) cases, adequate sulcus was present, in which foldable 3-piece IOL was placed in 29 (35%) cases.
Timing of intervention has no bearing on the final visual outcome after vitrectomy in cases of nucleus drop during phacoemulsification. The continuity of the capsulorrhexis and the availability of capsular support determines the type of placement of the lens. A foldable lens can be placed in the sulcus if continuous capsulorrhexis is present.
本研究旨在探讨白内障超声乳化术中核块下沉患者行晶状体后囊膜切开术（PPV）与校正距离视力（CDVA）之间的关系。
本回顾性分析纳入了 2017 年 7 月至 2019 年 11 月间因晶状体核或核碎片脱落而行 PPV 的 83 例患者。记录了初次白内障手术后行 PPV 的时间（≤2 周和＞2 周）。主要终点为术后 1 个月的 CDVA，并与行 PPV 的时间进行比较。如果 CDVA 优于或等于 20/40，则视预后良好，否则预后较差。还评估了管理方式以及植入的继发性人工晶状体（IOL）类型。
在因核块脱落而行玻璃体切割术的 83 例患者（55 例男性和 28 例女性）中，36 例在 2 周内行手术，47 例在 2 周至 1 个月内行手术。在 2 周内行手术的病例中，33 例获得了 20/20-20/40 的 CDVA。对于那些在 2 周后手术的患者，43 例获得了 20/20-20/40 的 CDVA。两组之间的视力结果差异无统计学意义（Fisher 确切检验，=0.97）。在 64 例（77%）有足够的巩膜嵴的病例中，有 29 例（35%）植入了折叠式 3 部件 IOL。
白内障超声乳化术中核块下沉患者行玻璃体切割术后，干预时机对最终视力结果无影响。连续的后囊膜切开术和囊袋支撑决定了晶状体的放置类型。如果存在连续的后囊膜切开术，可以将折叠式晶状体植入巩膜嵴内。
