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眼内晶状体再固定术降低眼内晶状体半脱位引起的高眼压患者眼压的效果。

Intraocular Pressure-Lowering Effect of Intraocular Lens Refixation in Patients with Elevated Intraocular Pressure Due to Intraocular Lens Subluxation.

机构信息

Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.

出版信息

Medicina (Kaunas). 2024 Sep 3;60(9):1440. doi: 10.3390/medicina60091440.

Abstract

To evaluate the surgical outcomes of intraocular lens (IOL) refixation with vitrectomy in patients with elevated intraocular pressure (IOP) due to IOL subluxation. : Patients with elevated IOP due to IOL subluxation who had undergone IOL refixation with vitrectomy between 1 June 2013 and 31 December 2023 were retrospectively evaluated. The primary outcome measure was surgical success or failure. Surgical success was defined as a reduction of ≥20% in the preoperative IOP or IOP ≤ 21 mmHg (criterion A), IOP ≤ 18 mmHg (criterion B), or IOP ≤ 15 mmHg (criterion C). Reoperation, loss of light perception, and hypotony were considered as surgical failure. The IOP, number of glaucoma medications used, postoperative complications, and visual acuity were evaluated as the secondary outcomes. The surgical outcomes were compared between the glaucoma and ocular hypertension (OH) groups. : At 12 months postoperatively, the probability of success was 72.5%, 54.1%, and 28.4% using criterion A, B, and C, respectively, and the mean IOP and mean number of glaucoma medications used had decreased significantly ( < 0.01 and = 0.03, respectively). Furthermore, the cumulative success rate was significantly higher in the OH group than in the glaucoma (100% vs. 47.4%; < 0.01) when using criterion A. Additional glaucoma surgery was required only in the glaucoma group. IOL refixation surgery significantly decreases the IOP and number of glaucoma medications required in patients with elevated IOP due to IOL subluxation. Thus, IOL refixation surgery alone without glaucoma surgery might be effective as the primary procedure in such patients.

摘要

评估玻璃体切除术后眼内晶状体(IOL)再固定治疗因 IOL 脱位导致眼内压(IOP)升高的手术效果。:回顾性评估了 2013 年 6 月 1 日至 2023 年 12 月 31 日期间因 IOL 脱位行玻璃体切除术后 IOL 再固定且伴有IOP升高的患者。主要结局指标为手术成功或失败。手术成功定义为术前IOP降低≥20%或IOP≤21mmHg(标准 A)、IOP≤18mmHg(标准 B)或IOP≤15mmHg(标准 C)。再次手术、光感丧失和低眼压被视为手术失败。眼压、使用的降眼压药物数量、术后并发症和视力被评估为次要结局。比较了青光眼和高眼压(OH)组的手术结果。:术后 12 个月,标准 A、B 和 C 下的成功率分别为 72.5%、54.1%和 28.4%,平均 IOP 和平均使用的降眼压药物数量均显著降低(<0.01 和=0.03)。此外,标准 A 下 OH 组的累积成功率明显高于青光眼组(100% vs. 47.4%;<0.01)。仅青光眼组需要额外的青光眼手术。IOL 再固定术可显著降低因 IOL 脱位导致的 IOP 升高患者的 IOP 和所需的降眼压药物数量。因此,对于此类患者,单独进行 IOL 再固定术而不进行青光眼手术可能是有效的主要治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d26c/11434365/30d0e595e650/medicina-60-01440-g001.jpg

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