白内障超声乳化术中后囊膜破裂风险因素分析

doi:10.6040/j.issn.1673-3770.0.2017.267

摘要/Abstract

摘要： 目的探讨白内障超声乳化术中晶状体后囊膜破裂的风险因素。方法回顾性分析2014年1月1日至2016年12月31日间行超声乳化白内障吸除术患者的临床资料,发生晶状体后囊膜破裂的38例(42眼)作为研究组,按1∶5的比例从剩余患者中随机选取190例(215眼)未发生晶状体后囊膜破裂的患者作为对照组。多因素Logistic回归分析超声乳化白内障吸除术中发生晶状体后囊膜破裂的危险因素。结果单因素分析表明性别、术前视力、视网膜脱离手术、玻璃体手术、玻璃体积血以及晶状体核分型是影响超声乳化白内障吸除术中发生晶状体后囊膜破裂的危险因素(P<0.05),多因素 Logistic 回归分析发现, 超声乳化白内障吸除术中发生晶状体后囊膜破裂的危险因素有术前视力<20/200、玻璃体积血和核分级。结论术前视力<20/200、有玻璃体积血病史及晶状体核分级较高的患者在行超声乳化白内障吸除术中晶状体后囊膜破裂的发生风险较高。

关键词: 多因素分析, 晶状体后囊膜破裂, 超声乳化白内障吸除术

Abstract: Objective To identify the risk factors for rupture of the posterior capsule during phacoemulsification cataract surgery. Methods The clinical data for patients who underwent phacoemulsification cataract surgery at our hospital between January 1, 2014 and December 31, 2016 were retrospectively reviewed. The data for 42 eyes(38 patients)in which posterior capsule rupture occurred intraoperatively were compared to those for 215 randomly selected eyes(190 patients)in which posterior capsule rupture did not occur(ratio 1∶5). Univariate and multivariate logistic regression models were used to identify risk factors for posterior capsule rupture during phacoemulsification cataract surgery. Results Univariate analysis revealed that patient sex, preoperative visual acuity <20/200, surgery for retinal detachment, vitreous surgery, vitreous hemorrhage, and nuclear stage were associated with rupture of the posterior capsule during phacoemulsification cataract surgery. In multivariate analysis, preoperative visual acuity <20/200, vitreous hemorrhage, and degree of nuclear sclerosis remained as independent risk factors for posterior capsule rupture in phacoemulsification cataract surgery. Conclusion Posterior capsular rupture is more likely to occur during phacoemulsification cataract surgery in patients with a preoperative visual acuity <20/200, vitreous hemorrhage, and a higher degree of nuclear sclerosis.

Key words: Phacoemulsification surgery, Posterior capsule rupture, Multivariate analysis

中图分类号:

R776.1

李厚秀,刘中华,陈智. 白内障超声乳化术中后囊膜破裂风险因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 88-90.

LI Houxiu, LIU Zhonghua, CHEN Zhi. Risk factors for rupture of the capsule membrane during phacoemulsification cataract surgery[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 88-90.

参考文献

[1] 林孝诚,余文达,陈瑾. 超声乳化白内障吸除术中后囊膜破裂的处理体会[J]. 国际眼科杂志,2013,12(2):2504-2506. LIN Xiaochen, YU wenda, CHEN Jin. Treatment experience of posterior capsular rupture in phaco-cataract surgery[J]. Int J Ophthalmol, 2013, 12(2):2504-2506.
[2] 李春亭,朱振流. 超声乳化白内障吸除术治疗白内障的临床疗效观察[J]. 中国继续医学教育,2017,9(3):96-97. LI Chunting, ZHU Zhenliu. Clinical observation on phacoemulsification for cataract[J]. Chin Cont Med Edu, 2017, 9(3):96-97.
[3] 李春丽. 同轴1.8mm微切口白内障超声乳化吸除术治疗硬核白内障的临床疗效观察[J]. 临床眼科杂志,2017,25(4): 312-315. LI Chunli. Clinical outcomes of 1.8 mm coaxial micro incision phacoemulsification in the treatment for hard nucleus cataract[J]. J Clin Ophthalmol, 2017, 25(4):312-315.
[4] Hong AR, Sheybani A, Huang AJ. Intraoperative management of posterior capsular ruptre[J]. Curr Opin Ophthalmol, 2015, 26(1):16-21.
[5] 章露易,徐雯,姚克,等. 超声乳化白内障吸除术中晶状体后囊膜破裂风险因素分析[J]. 中华眼科杂志,2015,51(4):282-287. ZHANG Luyi, XU Wen, YAO Ke. The risk factors of posterior capsule rupture in phacoemulsification of cataract[J]. Chin J Ophthalmol, 2015, 51(4):282-287.
[6] 谢涛,杨亚新,李新霞. 超声乳化白内障吸除术中发生晶状体后囊膜破裂的风险因素及预后效果分析[J]. 中国医学创新,2016,13(14):15-19. XIE Tao, YANG Yaxin, LI Xinxia. The prognosis and risk factors of posterior capsule rupture in phacoemulsification of cataract[J]. Med Innov Chin, 2016, 13(14):15-19.
[7] 李达,王丽丽,朱飞. 超声乳化白内障吸除术中发生晶状体后囊膜破裂的危险因素分析[J]. 宁夏医科大学学报,2016,38(8):941-944. LI Da, WANG Lili, ZHU Fei. The risk factors of posterior capsule rupture in phacoemulsification of cataract[J]. J Ningxia Med Univ, 2016, 38(8):941-944.
[8] 许衍辉,董玮,宫献珍,等. 超声乳化白内障吸除术中晶状体后囊膜破裂风险因素及预后分析[J]. 中国现代医学杂志,2016,26(22):116-119. XU Yanhui, DONG Wei, GONG Xianzhen, et al. Risk factors and prognosis of posterior capsule rupture in phacoemulsification of cataract[J]. Chin J Mod Med, 2016, 26(22):116-119.
[9] Chen M, Lamattina KC, Patrianakos T, et al. Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center:a clinical audit[J]. Clin Ophthalmol, 2014, 8:375-378.
[10] Narendran N, Jaycock P, Johnston RL, et al. The Cataract National Dataset electronic multicentre audit of 55,567 operations:risk stratification for posterior capsule rupture and vitreous loss[J]. Eye(Lond), 2009, 23(1):31-37.
[11] Artzen D, Lundstrom M, Behndig A, et al. Capsule complication during cataract surgery: Case-control study of preoperative and intraoperative risk factors: Swedish Capsule Rupture Study Group report 2[J]. J Cataract Refract Surg, 2009, 35(10):1688-1693.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed