Postel E A, Pulido J S, Byrnes G A, Heier J, Waterhouse W, Han D P, Mieler W F, Guse C, Wipplinger W
Duke University Medical Center, USA.
Arch Ophthalmol. 1998 Jun;116(6):753-7. doi: 10.1001/archopht.116.6.753.
To evaluate the outcomes of a group of patients who suffered iatrogenic phototoxic injury.
The medical records of 24 patients (24 eyes) with iatrogenic phototoxicity from 3 medical centers were reviewed. We report the findings from long-term follow-up of these patients with particular attention to visual outcome, type and duration of procedure, and location of the phototoxic lesion.
Phototoxic injury occurred after anterior segment surgery in 20 eyes and after vitrectomy in 4 eyes. The mean duration of surgery was 109 minutes; there was no statistically significant difference in duration between the anterior segment procedures and the vitrectomies. Mean final visual acuity was 20/40 for all cases (range, 20/15 to counting fingers) and 20/25 for all anterior segment cases. In vitrectomized eyes, the mean final visual acuity was 20/900. Phototoxic lesions tended to spare the fovea after anterior segment surgery and involve the foveal center after vitrectomy.
In general, patients who suffer phototoxicity do well, and the prognosis is good for extrafoveal lesions. Foveal injury, which often occurs with vitrectomy, usually leads to a worse visual outcome. The development of choroidal neovascularization may have an effect on the ultimate visual outcome as well.
评估一组遭受医源性光毒性损伤患者的治疗结果。
回顾了来自3个医疗中心的24例（24只眼）医源性光毒性患者的病历。我们报告了这些患者的长期随访结果，特别关注视力结果、手术类型和持续时间以及光毒性病变的位置。
20只眼前节手术后发生光毒性损伤，4只眼玻璃体切除术后发生光毒性损伤。手术平均持续时间为109分钟；前节手术和玻璃体切除术的持续时间在统计学上无显著差异。所有病例的平均最终视力为20/40（范围为20/15至数指），所有前节病例的平均最终视力为20/25。在接受玻璃体切除术的眼中，平均最终视力为20/900。前节手术后光毒性病变倾向于不累及黄斑中心凹，而玻璃体切除术后则累及黄斑中心凹。
一般来说，遭受光毒性的患者预后良好，黄斑外病变的预后较好。黄斑损伤常发生于玻璃体切除术，通常会导致更差的视力结果。脉络膜新生血管的形成也可能对最终的视力结果产生影响。
