白内障手术后出现视网膜撕裂和视网膜脱离，且曾接受过法光性视网膜撕裂治疗。

IF 13.1 1区医学 Q1 OPHTHALMOLOGY

Ophthalmology Pub Date : 2024-07-02 DOI:10.1016/j.ophtha.2024.06.021

Bita Momenaei MD , Andrew Zhou BS , Adina S. Kazan BS , Taku Wakabayashi MD, PhD , Anthony Obeid MD , Michael Morano MD , M. Ali Khan MD , David Xu MD , Ajay E. Kuriyan MD , Yoshihiro Yonekawa MD , Jason Hsu MD , Allen C. Ho MD

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引用次数: 0

摘要

目的研究既往有法球RT史的白内障摘除术后视网膜撕裂（RT）和视网膜脱离（RD）的发生率和结局：设计：回顾性病例系列：方法：回顾性病例系列：方法：对 2012 年 4 月 1 日至 2023 年 5 月 31 日期间接受 RT 治疗的法眼进行回顾性研究。排除因素包括白内障摘除术前曾接受玻璃体视网膜手术，以及白内障手术后随访不足 6 个月：主要结果指标：白内障手术后RT和RD的发生率，以及视觉和解剖结果：在12109只接受RT治疗的人工晶体眼中，有1039只（8.6%）接受了白内障手术。经排除后，对 660 名患者的 713 只眼睛进行了研究。白内障手术后的平均（标准差，SD）随访时间为 34.8（24.6）个月，出现新的 RT 或 RD 的中位时间分别为 239 天和 246 天。白内障手术后 RT 和 RD 的总发病率为 7.3%（52/713）（分别为 2.9% 和 4.3%），一年的发病率为 5.6%（分别为 2.2% 和 3.4%）。多变量回归分析发现，年龄较小的患者（几率比 [OR] 1.034；95% 置信区间 [CI] 1.004-1.065，P=0.028）、男性（OR 2.058；95% CI 1.110-3.816，P=0.022）和激光治疗与白内障手术间隔时间较短的患者（OR 1.001；95% CI 1.001-1.001，P=0.011）发生 RT/RD 的风险较高。25 只眼睛（80.6%）在 3 个月时进行了 RD 修复，单次手术解剖成功，最终重新接合率为 100%。RT的最终logMAR视力中位数为0.10（20/25），与白内障手术后相比无明显变化；RD的最终logMAR视力中位数为0.18（20/30），与白内障手术后相比明显恶化：结论：白内障手术后一年，曾接受过RT治疗的患者确诊RT和RD的比例相对较高，几乎每18只眼睛中就有1只。年轻人、男性和 RT 初次治疗与白内障手术间隔时间较短的患者的风险更高。RD修复术取得了良好的解剖效果，但视力有所下降。

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Retinal Tear and Retinal Detachment after Cataract Surgery in Eyes with a Previous History of Treated Phakic Retinal Tears

Purpose

To investigate the incidence and outcomes of retinal tear (RT) and retinal detachment (RD) after cataract extraction in patients with a history of previous phakic RT.

Design

Retrospective case series.

Participants

Patients with phakic eyes with RT that were treated successfully with laser photocoagulation or cryotherapy and subsequently underwent cataract surgery.

Methods

A retrospective review of data between April 1, 2012, and May 31, 2023, was performed. Exclusions included prior vitreoretinal surgery before cataract removal and follow-up of less than 6 months after cataract surgery.

Main Outcome Measures

The incidence of RTs and RDs after cataract surgery, along with visual and anatomic outcomes.

Results

Of 12 109 phakic eyes treated for RTs, 1039 eyes (8.6%) underwent cataract surgery. After exclusions, 713 eyes of 660 patients were studied. The mean ± standard deviation follow-up period after cataract surgery was 34.8 ± 24.6 months, with a median of 239 and 246 days to a new RT or RD development, respectively. The overall incidence of RT and RD diagnosis after cataract surgery was 7.3% (52/713; 2.9% and 4.3%, respectively), with a 1-year incidence of 5.6% (2.2% and 3.4%, respectively). Multivariable regression analysis identified a higher risk of RT and RD among younger individuals (odds ratio [OR], 1.034; P = 0.028), male patients (OR, 2.058; P = 0.022), and those with a shorter interval between laser treatment and cataract surgery (OR, 1.001; P = 0.011). Single-surgery anatomic success for the RD repair was achieved in 25 eyes (80.6%) at 3 months, with a 100% final reattachment rate. The median final visual acuity was 0.10 logarithm of the minimum angle of resolution (logMAR; Snellen equivalent, 20/25) for RT, showing no significant change from after cataract surgery, and 0.18 logMAR (Snellen equivalent, 20/30) for RD, a significant worsening from after cataract surgery.

Conclusions

One year after cataract surgery, the rate of diagnosed RT and RD in patients with previously treated RTs was relatively high, occurring in nearly 1 in 18 eyes. Higher risk was noted among younger individuals, male patients, and patients with a shorter interval between initial treatment for RT and cataract surgery. Retinal detachment repair achieved good anatomic results, but vision declined.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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来源期刊

Ophthalmology 医学-眼科学

CiteScore

22.30

自引率

3.60%

发文量

412

审稿时长

18 days

期刊介绍： The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.