Montrimas Andrius, Rinkevičiūtė Jorė, Žemaitienė Reda
Department of Ophthalmology, Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, 50161, Lithuania.
Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
BMC Ophthalmol. 2025 Apr 10;25(1):197. doi: 10.1186/s12886-025-04023-w.
The study aimed to identify factors influencing the time from cataract surgery to PCO treatment with Neodymium: Yttrium-Aluminium-Garnet (Nd: YAG) laser.
For PCO risk factors analysis the retrospective study included 1045 eyes treated for PCO using Nd: YAG laser capsulotomy in the Hospital of Lithuanian University of Health Sciences (HLUHS) Kaunas Clinics with reduced best-corrected distance visual acuity (BCDVA) and opacity in the central 3 mm zone. Eyes with no comorbidities were categorized into groups according to the intraocular lense (IOL) implanted and the time from cataract operation to Nd: YAG capsulotomy was compared. Tests used for statistical analysis: Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, one-way independent ANOVA, Pearson's or Spearman's correlation coefficient, and multivariable linear regression.
A total of 918 patients (1045 eyes) were included. The median time from cataract surgery to capsulotomy was 39.0 (27.4-54.6) months (min. 2; max. 174), did not differ between men and women, and was shorter for junior surgeons (25.8 (19.8-35.1) months) compared to senior surgeons (39.6 (27.8-55.3) months) (p < 0.001). Seven factors affecting the time from cataract surgery to Nd: YAG capsulotomy were found: IOL model, surgeon's experience, BCDVA after surgery, capsular tension ring, pseudoexfoliation, BCDVA before capsulotomy and exudative age-related macular degeneration (adjusted R = 0.452; p < 0.001). The IOL model was the only factor with a strong correlation. The median time from cataract surgery to capsulotomy differed between all IOL groups: Acriva UD613 group 31.5 (23.0-38.0) months, Johnson&Johnson Tecnis ZCB00 group 41.0 (33.5-66.5) months, Bausch&Lomb Envista MX60 group 45.0 (38.5-54.5) months, and Alcon Acrysof IQ SN60WF group 53.0 (41.5-79.5) months.
The IOL model seems to have the greatest influence on the time from cataract surgery to Nd: YAG capsulotomy. Acrylic hydrophobic IOLs with a square optical edge have different times from cataract surgery to Nd: YAG capsulotomy. Hydrophobic acrylic IOL seems to have a longer time from cataract surgery to Nd: YAG capsulotomy compared to hydrophilic acrylic IOL with a hydrophobic surface.
本研究旨在确定影响白内障手术后至使用钕:钇铝石榴石(Nd:YAG)激光进行后发性白内障(PCO)治疗时间的因素。
对于PCO危险因素分析,这项回顾性研究纳入了立陶宛卫生科学大学(HLUHS)考纳斯诊所1045只接受Nd:YAG激光晶状体囊切开术治疗PCO的眼睛,这些眼睛最佳矫正远视力(BCDVA)下降且中央3毫米区域有混浊。无合并症的眼睛根据植入的人工晶状体(IOL)进行分组,并比较白内障手术至Nd:YAG晶状体囊切开术的时间。用于统计分析的测试:夏皮罗-威尔克检验、克鲁斯卡尔-沃利斯检验、曼-惠特尼检验、单因素独立方差分析、皮尔逊或斯皮尔曼相关系数以及多变量线性回归。
共纳入918例患者(1045只眼)。白内障手术至晶状体囊切开术的中位时间为39.0(27.4 - 54.6)个月(最短2个月;最长174个月),男女之间无差异,与资深外科医生(39.6(27.8 - 55.3)个月)相比,初级外科医生的时间更短(25.8(19.8 - 35.1)个月)(p < 0.001)。发现了七个影响白内障手术至Nd:YAG晶状体囊切开术时间的因素:IOL型号、外科医生经验、术后BCDVA、囊张力环、假性剥脱、晶状体囊切开术前BCDVA以及渗出性年龄相关性黄斑变性(调整后R = 0.452;p < 0.001)。IOL型号是唯一具有强相关性的因素。所有IOL组白内障手术至晶状体囊切开术的中位时间不同:Acriva UD613组31.5(23.0 - 38.0)个月,强生Tecnis ZCB00组41.0(33.5 - 66.5)个月,博士伦Envista MX60组45.0(38.5 - 54.5)个月,爱尔康Acrysof IQ SN60WF组53.0(41.5 - 79.5)个月。
IOL型号似乎对白内障手术至Nd:YAG晶状体囊切开术的时间影响最大。具有方形光学边缘的丙烯酸疏水IOL从白内障手术至Nd:YAG晶状体囊切开术的时间不同。与具有疏水表面的亲水丙烯酸IOL相比,疏水丙烯酸IOL从白内障手术至Nd:YAG晶状体囊切开术的时间似乎更长。