首页|玻璃体切除联合一期晶状体后囊膜切除对白内障手术后屈光结果及前房深度的影响

玻璃体切除联合一期晶状体后囊膜切除对白内障手术后屈光结果及前房深度的影响

The impact of primary posterior capsulotomy on the refractive outcomes and anterior chamber depth after phaco-vitrectomy

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目的 分析玻璃体切除(pars plana vitrectomy,PPV)联合白内障手术中一期进行晶状体后囊膜切除(posterior capsu-lotomv,PC)对术后屈光结果及前房深度的影响:设计前瞻性非随机对照研究.研究对象2021年9月至2022年9月因全层黄斑裂孔、黄斑前膜或玻璃体黄斑牵拉综合征行白内障摘除、IOL植入、PPV联合PC术患者50例(50眼)(PhacoPPVc组),或由于单纯白内障需接受白内障摘除联合IOL植入的患者50例(50眼)(Phaco组).方法 使用Barrett UⅡ公式进行两组患者IOL屈光度计算.记录患者术前和术后1个月最佳矫正视力、屈光误差(predictive error,PE)、前房深度(anterior chamber depth,ACD)、PE的标准差、平均绝对误差、绝对误差中位数和PE在±0.25 D、±0.50 D、±0.75 D和±1.00 D范围内的比例.主要指标术后PE及ACD.结果 Phaco组术后PE为(0.054±0.397)D,而PhacoPPVc组为(-0.091±0.668)D,两组与0比较均无统计学差异(t=0.962,P=0.341;t=-0.963,P=0.340).术后 1 个月两组 ACD 均较术前加深,Phaco组为(4.407±0.324)mm,PhacoPPVc 组为(4.259±0.254)mm,但PhacoPPVc组的ACD较Phaco组明显变浅,差异具有显著性(t=2.537,P=0.013).PhacoPPVc组患者的屈光预测准确性较差,标准差、平均绝对误差、绝对误差中位数均高于Phaco组,而在所有给定范围内的比例均低于Phaco组.结论 与单纯白内障组比,PPV联合白内障手术中同时进行PC术后1个月时ACD显著变浅,尽管PhacoPPVc组未出现明显的近视或远视误差,但其屈光预测准确性低于单纯白内障组.(眼科,2024,33:200-204)
Objective To analyze the impact of primary posterior capsulotomy(PC)in phaco-vitrectomy on postoperative refractive outcomes and anterior chamber depth(ACD).Design Prospective non-randomized controlled study.Parcitipants Between September 1,2021 and September 30,2022,50 patients(50 eyes)in the triple group who underwent Phaco-vitrectomy combined with PC surgery due to full-thickness macular hole,epiretinal membrane,or vitreoretinal traction syndrome,and 50 patients(50 eyes)in the control group who needed cataract extraction combined with IOL implantation due to cataracts were prospectively recruited.Methods The Barrett UⅡformula was used to calculate the IOL power for all the patients.The best corrected visual acuity,refractive error(PE),anterior chamber depth(ACD),standard deviation,mean absolute error,median absolute error,and percentage of eyes with PE within±0.25 D,±0.50 D,±0.75 D,and±1.00 D for all patients before and 1 month after surgery were checked and recorded.Main Outcome Measures Postop-erative PE and ACD.Results The postoperative PE of the control group was 0.054±0.397 D,and that of the triple group was-0.091±0.668 D.Both groups showed no systematic error compared to 0(t=0.962,P=0.341,and t=-0.963,P=0.340,respectively).The postop-erative ACD in both groups deepened compared to preoperative levels,with a control group of 4.407±0.324 mm and a triple group of 4.259±0.254 mm.However,the ACD in the triple group was shallower than that in the control group,with a significant difference(t=2.537,P=0.013).The accuracy of refractive prediction in the triple group patients was poor,manifested as higher standard deviation,mean absolute error,and median absolute error compared to the control group,while the percentage of eyes in all given PE ranges was lower than that in the cataract group.Conclusions Compared with the cataract group,simultaneous use of PC during phaco-vitrectomy resulted in a significant shallowness in ACD at 1 month post-surgery.Although the triple group did not show significant myopic or hy-peropic errors,its accuracy in predicting refractive error was significantly lower than that of the cataract group.(Ophthalmol CHN,2024,33;200-204)

cataractpars plana vitrectomyposterior capsulotomyrefractive erroranterior chamber depth

何渊、朱静芬、赵世强、綦碧莹、杨文利、刘武

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首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,北京 100730

上海交通大学医学院,上海 200025

白内障 玻璃体切除术 后囊膜切除 屈光误差 前房深度

国家自然科学基金

T2293730

2024

眼科
中日友好医院,北京同仁医院,北京市眼科研究所

眼科

CSTPCD
影响因子:0.483
ISSN:1004-4469
年,卷(期):2024.33(3)