Martin T P, Reed J W, Legault C, Oberfeld S M, Jacoby B G, Yu D D, Dickens A, Johnson H P
Department of Ophthalmology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1033.
Ophthalmology. 1994 Jan;101(1):113-9. doi: 10.1016/s0161-6420(13)31252-4.
This retrospective study was done to identify risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined procedure (simultaneous cataract extraction with keratoplasty) or penetrating keratoplasty alone should be performed.
Variables from 342 phakic eyes having undergone penetrating keratoplasties were studied with univariate and multivariate analyses, including diagnosis, race, sex, age, preoperative lens opacities, preoperative vision, and length of follow-up.
For cataract formation, age was the only independent risk factor found by multivariate analysis (P = 0.0001). For cataract extraction after penetrating keratoplasty, independent risk factors included age, sex, diagnosis, and preoperative lens opacities (P < or = 0.03). For example, the probability of a 65-year-old patient with Fuchs dystrophy requiring a cataract extraction within 5 years of keratoplasty is 81%.
The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increases greatly after 50 years of age, regardless of the diagnosis leading to the need for keratoplasty. The need for cataract extraction also is increased for female patients, for patients with Fuchs dystrophy, and for those with early preoperative lens opacity.
本回顾性研究旨在确定穿透性角膜移植术后白内障形成和白内障摘除的危险因素，以决定是应采用联合手术（角膜移植术同时行白内障摘除）还是单独进行穿透性角膜移植术。
对342例接受穿透性角膜移植术的有晶状体眼的变量进行单因素和多因素分析，包括诊断、种族、性别、年龄、术前晶状体混浊情况、术前视力及随访时间。
对于白内障形成，多因素分析发现年龄是唯一的独立危险因素（P = 0.0001）。对于穿透性角膜移植术后的白内障摘除，独立危险因素包括年龄、性别、诊断及术前晶状体混浊情况（P≤0.03）。例如，一名65岁患有富克斯营养不良的患者在角膜移植术后5年内需要进行白内障摘除的概率为81%。
50岁以后，无论导致角膜移植术的诊断如何，穿透性角膜移植术后白内障形成和白内障摘除的可能性都会大幅增加。女性患者、患有富克斯营养不良的患者以及术前晶状体早期混浊的患者白内障摘除的需求也会增加。
