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在假性剥脱综合征背景下,预防年龄相关性白内障患者发生假性剥脱性青光眼。

Prevention of pseudoexfoliation glaucoma in patients with age-related cataract in the background of pseudoexfoliation syndrome.

作者信息

Mеlnyk Volodymyr О, Likhatska Аnastasiia О, Haliienko Liudmyla І, Palamar Borys І

机构信息

BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; LLC«VISIOBUD CLINIC», KYIV, UKRAINE.

LLC«VISIOBUD CLINIC», KYIV, UKRAINE.

出版信息

Pol Merkur Lekarski. 2025;53(4):473-477. doi: 10.36740/Merkur202504106.

DOI:10.36740/Merkur202504106
PMID:40929536
Abstract

OBJECTIVE

Aim: To evaluate the possibility of using cataract phacoemulsification with simultaneous intraocular lens (IOL) implantation in patients with age-related cataract (ARC) combined with pseudoexfoliation syndrome (PES) as an algorithm for the pseudoexfoliation glaucoma (PEG) prevention..

PATIENTS AND METHODS

Materials and Methods: A retrospective case-control study was conducted using data from medical records of 610 outpatients (813 eyes) with ARC aged from 49 to 79 years (average age 69 ± 3 years). Group 1 included 488 patients (625 eyes) with ARC and PES, and Group 2 (control) included 122 patients (188 eyes) without signs of PES. Patients in both groups underwent ultrasonic phacoemulsification and IOL implantation.

RESULTS

Results: Patients from Group 1 presented with less anterior chamber depth, a thicker lens, and higher intraocular pressure (IOP), as compared to Group 2. In patients with PES after cataract surgery, we observed a slight increase in IOP during the first week, followed by a significant decrease (by 3.1 mm Hg) during the next 3 months (vs. baseline; p<0,001). In patients without PES, a slow decrease in IOP (by 1,0 mm Hg) was observed during 3 months after surgery (vs. baseline; p<0,001). The cataract surgery favored an increase in anterior chamber depth by 45,2 % in patients with ARC and PES.

CONCLUSION

Conclusions: Ultrasonic cataract phacoemulsification with IOL implantation in patients with PES leads to a significant decrease and stabilization of IOP in the long-term postoperative period (3-month follow-up), and may be an alternative method for the prevention of PEG development.

摘要

目的

评估在年龄相关性白内障(ARC)合并假性剥脱综合征(PES)的患者中使用白内障超声乳化吸除联合人工晶状体(IOL)植入术作为预防假性剥脱性青光眼(PEG)的一种方法的可能性。

患者与方法

材料与方法:进行一项回顾性病例对照研究,使用610例年龄在49至79岁(平均年龄69±3岁)的ARC门诊患者(813只眼)的病历数据。第1组包括488例ARC合并PES患者(625只眼),第2组(对照组)包括122例无PES体征的患者(188只眼)。两组患者均接受超声乳化白内障吸除术及IOL植入术。

结果

结果:与第2组相比,第1组患者的前房深度较浅、晶状体较厚且眼压较高。在白内障手术后患有PES的患者中,我们观察到术后第一周眼压略有升高,随后在接下来的3个月内显著下降(下降3.1 mmHg)(与基线相比;p<0.001)。在无PES的患者中,术后3个月观察到眼压缓慢下降(下降1.0 mmHg)(与基线相比;p<0.001)。白内障手术使ARC合并PES患者的前房深度增加了45.2%。

结论

结论:在患有PES的患者中进行超声乳化白内障吸除联合IOL植入术可使术后长期(3个月随访)眼压显著降低并稳定,可能是预防PEG发生的一种替代方法。

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