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复杂白内障手术中改良矢野技术的时机:同期进行还是分两期进行?

Timing of the modified yamane technique in complicated cataract surgery: same session or second session?

作者信息

Icoz Mehmet, Erkan Eyüp

机构信息

Department of Ophthalmology, Yozgat City Hospital, Erdoğan Akdağ Mah, Viyana Cad., Merkez, 66100, Yozgat, Turkey.

Department of Ophthalmology, Faculty of Medicine, Yozgat Bozok University, Adnan Menderes Bulvarı, Merkez, 66100, Yozgat, Turkey.

出版信息

Int Ophthalmol. 2025 May 19;45(1):205. doi: 10.1007/s10792-025-03571-w.

DOI:10.1007/s10792-025-03571-w
PMID:40387987
Abstract

PURPOSE

This study aimed to evaluate the timing of the modified Yamane technique (MYT) in complicated cataract surgery where capsular support is lost.

METHODS

This retrospective study was conducted on 41 eyes of 41 patients. Participants who underwent the MYT during primary cataract surgery were classified as group P(n = 12),while those who underwent the technique in a second session after cataract surgery were classified as group S(n = 29).Preoperative and postoperative ophthalmological findings were examined in both groups.

RESULTS

In group S,the mean time between the two surgeries was 18 days (range:6-32 days).Preoperative intraocular pressure was 12.5 ± 2.9 mmHg in group P and 15.1 ± 1.9 mmHg in group S(p = 0.02).At the postoperative six-month follow-up, no significant differences were observed between the two groups in relation to visual acuity, refraction measurements, or intraocular pressure values(p > 0.05 for all). Central macular thickness was measured as 274 ± 18 microns(range:236-291 microns) in group P and 254 ± 11 microns (range:229-272 microns) in group S(p = 0.02).In the early postoperative period (< 1 month),cystoid macular edema occurred in two cases(16.6%) in group P, while one case(8.3%) of increased intraocular pressure and one case(8.3%) of severe corneal edema were observed. In group S, cystoid macular edema occurred in one case(3.4%).No complications were detected in either group during the late postoperative period.

CONCLUSION

In cases of complicated cataract with loss of capsular support,the MYT,whether performed in the same session or in a second session, yielded comparable visual and refractive outcomes. While complications were more frequent in the early postoperative period in the group undergoing surgery in the same session,no complications were observed in either group during the late postoperative period.

摘要

目的

本研究旨在评估改良矢根技术(MYT)在囊膜支持丧失的复杂白内障手术中的应用时机。

方法

本回顾性研究纳入了41例患者的41只眼。在初次白内障手术中接受MYT的参与者被归类为P组(n = 12),而在白内障手术后的第二阶段接受该技术的参与者被归类为S组(n = 29)。对两组患者术前和术后的眼科检查结果进行了评估。

结果

在S组中,两次手术之间的平均时间为18天(范围:6 - 32天)。P组术前眼压为12.5±2.9 mmHg,S组为15.1±1.9 mmHg(p = 0.02)。术后6个月随访时,两组在视力、屈光测量或眼压值方面均未观察到显著差异(所有p>0.05)。P组中心黄斑厚度测量为274±18微米(范围:236 - 291微米),S组为254±11微米(范围:229 - 272微米)(p = 0.02)。术后早期(<1个月),P组有2例(16.6%)发生囊样黄斑水肿,同时观察到1例(8.3%)眼压升高和1例(8.3%)严重角膜水肿。在S组中,有1例(3.4%)发生囊样黄斑水肿。术后晚期两组均未检测到并发症。

结论

在囊膜支持丧失的复杂白内障病例中,无论在同一次手术中还是在第二次手术中进行MYT,视觉和屈光结果都相当。虽然在同一次手术的组中术后早期并发症更频繁,但术后晚期两组均未观察到并发症。

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本文引用的文献

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Eye Vis (Lond). 2024 Dec 30;11(1):49. doi: 10.1186/s40662-024-00414-0.
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Clinical Outcomes in Scleral Fixation Secondary Intraocular Lens with Yamane versus Suture Techniques: A Systematic Review and Meta-Analysis.Yamane巩膜固定人工晶状体与缝线技术的临床结局:一项系统评价和荟萃分析
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