联合晶状体切除术与序贯晶状体切除术在眼内的后续人工晶状体手术。

IF 3.3 4区 医学 Q1 OPHTHALMOLOGY
Fatma F Shakarchi, Ahmed F Shakarchi, Mohamed K Soliman, Abdallah A Ellabban, Ahmed B Sallam
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引用次数: 0

摘要

目的:探讨联合或序贯晶状体切除术后人工晶状体手术的危险因素。设计:回顾性队列研究。参与者:2003年7月至2015年3月期间在8个英国国家卫生服务临床中心接受超声乳化术的成年患者。因核碎片脱落、青光眼或虹膜问题而接受手术的患者被排除在外。方法:将既往玻璃体手术组、联合玻璃体手术组、既往玻璃体手术组和目前联合玻璃体手术组分为3组。根据术前眼部和全身因素、术中发现以及随后进行第二次人工晶状体手术的需要对这两组进行比较。采用泊松模型计算调整后相对危险度(aRR)。结果:纳入5215只眼:既往玻璃体切除术2124只眼,联合玻璃体切除术2512只眼,既往玻璃体切除术和目前联合玻璃体切除术579只眼。既往玻璃体切除术的眼术后IOL手术风险为0.6%(参照组),目前联合玻璃体切除术的眼术后IOL手术风险为1.6% (aRR 2.6, CI: 1.4-5.1),既往加目前联合玻璃体切除术的眼术后IOL手术风险为3.3% (aRR 3.8, CI: 1.7-8.3)。其他重要的危险因素是年龄(aRR 0.98/年)、假脱落(aRR 6.76, CI: 2-28)、区域透析(aRR 10.6, CI: 4.8-24)、当前手术中的巩膜扣(aRR 8.05, CI: 4-14)和使用硅油(aRR 3.6, CI: 1.6-8.4)与无填塞相比。结论:与序贯手术相比,晶状体-玻璃体联合手术发生人工晶状体并发症的风险更高。这一信息对需要白内障和视网膜手术的患者的手术计划是有用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subsequent intraocular lens surgery in eyes with combined versus sequential phacovitrectomy.

Objective: To determine the risk factors for subsequent intraocular lens (IOL) surgery among eyes undergoing either combined or sequential phacovitrectomy.

Design: Retrospective cohort study.

Participants: Adult patients undergoing phacoemulsification at 8 United Kingdom National Health Service clinical centers between July 2003 and March 2015. Patients undergoing surgery for a dropped nucleus fragment, glaucoma, or iris problems were excluded.

Methods: The eyes were categorized into 3 groups: with previous vitrectomy, undergoing combined phacovitrectomy, and with both previous vitrectomy and current combined phacovitrectomy. These groups were compared based on preoperative ocular and systemic factors, intraoperative findings, and the subsequent need for a second IOL surgery. The Poisson model was used to calculate adjusted relative risks (aRR).

Results: 5,215 eyes were included: 2,124 with previous vitrectomy, 2,512 with combined phacovitrectomy, and 579 eyes with previous vitrectomy and currently combined phacovitrectomy. The risk of subsequent IOL surgery was 0.6% (reference group) in eyes with previous vitrectomy, 1.6% (aRR 2.6, CI: 1.4-5.1) in eyes with current combined phacovitrectomy, and 3.3% (aRR 3.8, CI: 1.7-8.3) in eyes with previous plus current combined phacovitrectomy. Other significant risk factors were age (aRR 0.98/year), pseudoexfoliation (aRR 6.76, CI: 2-28), zonular dialysis (aRR 10.6, CI: 4.8-24), scleral buckle in the current surgery (aRR 8.05, CI: 4-14), and the use of silicone oil (aRR 3.6, CI: 1.6-8.4) compared to no tamponade.

Conclusions: Combined phacovitrectomy was associated with a higher risk of IOL complications than sequential surgery. This information is useful for planning surgery in patients requiring both cataract and retinal surgeries.

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来源期刊
CiteScore
3.20
自引率
4.80%
发文量
223
审稿时长
38 days
期刊介绍: Official journal of the Canadian Ophthalmological Society. The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.
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