Elekes Ágnes, Vámosi Péter
Department of Ophthalmology, Péterfy Sándor Hospital, 1076 Budapest, Hungary.
Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary.
J Clin Med. 2024 Aug 17;13(16):4855. doi: 10.3390/jcm13164855.
: The surgical parameters of phacoemulsification can significantly impact the behavior of the anterior hyaloid membrane (AHM). : In this prospective study, anterior segment optical coherence tomography was used to examine the attachment or detachment of the AHM of 82 eyes after uneventful phacoemulsification preoperatively and postoperatively over 1 year. The impacts of the capsulorhexis' size, number of hydrodissections, nuclear sclerosis grade, cumulative dissipated energy (CDE), ultrasonic time, total surgical time, weakness of zonular fibers, presence of lens materials in Berger's space (LM-BS), and fluid usage were investigated in relation to the behavior of the AHM. : A significant linear trend regarding anterior vitreous detachment (AVD) was observed in the presence of zonular weakness and high CDE at all postoperative times ( ≤ 0.024 and ≤ 0.005, respectively). Similarly, AVD was observed at 1-month, 3-month, and 1-year follow-ups in cases of high nuclear sclerosis grades ( ≤ 0.044) and high fluid usage ( ≤ 0.021). A significant correlation was observed in the group of LM-BS as the zonular weakness value increased (OR: 0.085; 95% CI: 0.017 to 0.420; = 0.002), and the fluid usage was also significantly higher (OR: 1.049; 95% CI: 1.003-1.096; = 0.037). : Zonular weakness, high CDE, a hard nucleus, and high fluid usage are risk factors for postoperative AVD.
超声乳化手术参数可显著影响前玻璃体膜(AHM)的表现。在这项前瞻性研究中,采用眼前节光学相干断层扫描技术,对82只眼在白内障超声乳化手术平稳进行前后1年期间AHM的附着或脱离情况进行检查。研究了连续环形撕囊的大小、水分离次数、核硬化程度、累积释放能量(CDE)、超声时间、总手术时间、悬韧带纤维薄弱情况、晶状体物质在Berger间隙(LM-BS)中的存在情况以及液体使用量与AHM表现的关系。在所有术后时间点(分别≤0.024和≤0.005),观察到在存在悬韧带薄弱和高CDE的情况下,前玻璃体脱离(AVD)有显著的线性趋势。同样,在核硬化程度高(≤0.044)和液体使用量高(≤0.021)的病例中,在术后1个月、3个月和1年随访时观察到AVD。随着悬韧带薄弱值增加,在LM-BS组中观察到显著相关性(比值比:0.085;95%置信区间:0.017至0.420;P = 0.002),并且液体使用量也显著更高(比值比:1.049;95%置信区间:1.003 - 1.096;P = 0.037)。悬韧带薄弱、高CDE、硬核以及高液体使用量是术后AVD的危险因素。