玻璃体切割术后超声乳化联合人工晶状体植入术的屈光误差分析
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2021年陕西省重点研发计划项目(No.2021SF-161); 2019年西安市科技行动计划医学研究项目[No.2019115313YX008SF041(1)]


Refractive error analysis of phacoemulsification combined with intraocular lens implantation after vitrectomy
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Key Research and Development Program of Shaanxi Province in 2021(No.2021SF-161); Medical Research Project of Xi'an Science and Technology Action Plan in 2019\〖No.2019115313YX008SF041(1)\〗

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    摘要:

    目的:探讨玻璃体切割术后白内障患者Ⅱ期行白内障超声乳化抽吸联合人工晶状体(IOL)植入的屈光误差。

    方法:回顾性分析。选取既往行玻璃体切割术现发生白内障需行手术治疗的患者38例40眼。按既往玻璃体腔填充物分为2组,A组(22眼)为既往单纯行玻璃体切割组,B组(18眼)为既往行玻璃体切割联合惰性气体(C3F8)填充组。另设置无玻璃体切割手术史现需行白内障超声乳化抽吸手术的正常对照组C组(20眼)。术前应用IOL Master 500测量眼轴长度(AL)、角膜曲率(K)、前房深度(ACD),角膜横径(W-W),带入Barrett Universal Ⅱ公式计算IOL屈光度。A组、B组采用虹膜拉钩辅助的超声乳化抽吸联合IOL植入术,C组为单纯超声乳化抽吸联合IOL植入术。术中均无后囊膜破裂等并发症。术后3mo验光获得实测屈光度。比较3组的预测误差、绝对预测误差、绝对误差中位数。

    结果:三组间AL、K、植入IOL屈光度数均无差异(P>0.05)。A组、B组ACD均较C组显著加深(P<0.01)。三组间预测误差有差异(P=0.042),B组较C组有显著的远视漂移。绝对预测误差、绝对误差中位数在组间无差异。

    结论:单纯玻璃体切割术后Ⅱ期白内障超声乳化联合IOL植入,与正常对照组相比,术后屈光结果无显著差异; 但在玻璃体切割联合惰性气体填充术后患者,Ⅱ期白内障超声乳化抽吸术后会产生远视漂移,在选择IOL时应避免欠矫,适当过矫。

    Abstract:

    AIM: To evaluate the refractive errors after phacoemulsification combined with intraocular lens(IOL)implantation in previously vitrectomized eyes.

    METHODS: Thirty-eight patients(40 eyes)with cataract who had undergone vitrectomy were divided into two groups: vitrectomy alone as group A(22 eyes), vitrectomy combined with inert gas(C3F8)tamponade as group B(18 eyes). In addition, normal eyes(20 eyes)without vitrectomy history who required cataract surgery were included as a control group C. Axial length(AL), keratometric value(K), anterior chamber depth(ACD), and white-to-white(W-W)were measured with IOL Master 500 before the surgery. The power of IOL was calculated with the online Barrett Universal Ⅱ formula. Phacoemulsification combined with IOL implantation by an iris hook assistance technique was used to treat groups A and B, group C was treated only with phacoemulsification and IOL implantation. There were no complications, such as posterior capsule rupture. The postoperative refraction was obtained three months after surgery. The prediction error(PE), absolute prediction error(AE), and median absolute error(MedAE)among the three groups were compared.

    RESULTS: There was no significant difference among the three groups in AL, K value, and IOL power. A significantly deep ACD was noted in groups A and B compared with group C(P<0.01). There was a significant difference in the prediction error among the three groups(P=0.042). Group B showed a significant hyperopic shift compared with group C. AE and MedAE among groups showed no significant difference.

    CONCLUSION: There was no significant difference in the refractive results of patients with phacoemulsification sequential to vitrectomy alone compared with the normal control group. However, a hyperopic shift was found in patients with phacoemulsification sequential to vitrectomy with inert gas tamponade comparing with the normal eyes. Undercorrection should be avoided when selecting IOL power.

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王艳芬,Farheen Tariq,马挺,等.玻璃体切割术后超声乳化联合人工晶状体植入术的屈光误差分析.国际眼科杂志, 2021,21(12):2166-2169.

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  • 收稿日期:2021-05-14
  • 最后修改日期:2021-11-03
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  • 在线发布日期: 2021-11-22
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