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超声乳化白内障吸除术及巩膜固定人工晶状体植入术对脉络膜血管指数的影响:一项对比研究。

The effects of phacoemulsification and scleral-fixated intraocular lens implantation on the choroidal vascular index: A comparative study.

作者信息

Reyhan Ali Hakim, Şimşek Ali, Bulut Mübeccel, Yüksekyayla Funda, Uzun İrfan, Mutaf Çağri, Eryavuz Mehmet, Yosun Tuba

机构信息

Department of Ophthalmology, Harran University Faculty of Medicine, Sanliurfa, Türkiye.

Department of Ophthalmology, Necip Fazil City Hospital, Kahramanmaraş, Turkey.

出版信息

Medicine (Baltimore). 2025 Aug 8;104(32):e43814. doi: 10.1097/MD.0000000000043814.

Abstract

This study evaluates and compares choroidal vascular changes in patients undergoing phacoemulsification and scleral-fixated intraocular lens implantation. The research focused on assessing the choroidal vascular index (CVI) and choroidal thickness as indicators of vascular and structural integrity, using normal eyes as controls. This comparative study involved 135 eyes divided into 3 groups, phacoemulsification, scleral-fixated intraocular lens implantation, and control. Choroidal thickness and CVI were evaluated using optical coherence tomography within the first 3 months after surgery. Image binarization with ImageJ was used to calculate the luminal area, total choroidal area, and vascular index. No significant differences were determined in foveal choroidal thickness (P = .208; 274.48 ± 50.37 μm, 265.13 ± 41.68 μm, and 284.18 ± 58.69 μm for control, phacoemulsification, and scleral fixation groups, respectively) or temporal choroidal thickness (P = .243; 272.87 ± 51.37 μm, 267.71 ± 40.38 μm, and 284.60 ± 53.04 μm, respectively). However, nasal choroidal thicknesses differed between the groups (P < .05; 275.00 ± 45.13 μm, 261.53 ± 33.95 μm, and 285.14 ± 60.16 μm), with a significant difference between the phacoemulsification and scleral fixation groups (P = .024). Vascular parameters, including luminal area (P = .081), total subfoveal choroidal area (P = .070), and the CVI (P = .173), exhibited no statistically significant differences. While overall choroidal integrity remains preserved post-surgery, regional changes, particularly in the nasal choroid, suggest a localized hemodynamic response affected by surgical manipulation and inflammation. These findings highlight the importance of monitoring choroidal changes to improve postoperative management.

摘要

本研究评估并比较了接受白内障超声乳化吸除术和巩膜固定人工晶状体植入术患者的脉络膜血管变化。该研究聚焦于评估脉络膜血管指数(CVI)和脉络膜厚度,以此作为血管和结构完整性的指标,并以正常眼作为对照。这项对比研究纳入了135只眼睛,分为3组:白内障超声乳化吸除术组、巩膜固定人工晶状体植入术组和对照组。在术后前3个月内使用光学相干断层扫描评估脉络膜厚度和CVI。使用ImageJ进行图像二值化处理,以计算管腔面积、脉络膜总面积和血管指数。中央凹脉络膜厚度在各组间无显著差异(P = 0.208;对照组、白内障超声乳化吸除术组和巩膜固定术组分别为274.48±50.37μm、265.13±41.68μm和284.18±58.69μm),颞侧脉络膜厚度亦无显著差异(P = 0.243;分别为272.87±51.37μm、267.71±40.38μm和284.60±53.04μm)。然而,各组间鼻侧脉络膜厚度存在差异(P < 0.05;分别为275.00±45.13μm、261.53±33.95μm和285.14±60.16μm),白内障超声乳化吸除术组和巩膜固定术组之间存在显著差异(P = 0.024)。血管参数,包括管腔面积(P = 0.081)、中央凹下脉络膜总面积(P = 0.070)和CVI(P = 0.173),均无统计学显著差异。虽然术后脉络膜整体完整性得以保留,但局部变化,尤其是鼻侧脉络膜的变化,提示存在受手术操作和炎症影响的局部血流动力学反应。这些发现凸显了监测脉络膜变化以改善术后管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0138/12338238/48d2e270d5b3/medi-104-e43814-g001.jpg

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