文章摘要
谢梅傲,代 敏,王 英,李用真,黄学思.超声乳化吸除联合人工晶体植入术治疗白内障的疗效及术后前房渗出的影响因素分析[J].,2022,(6):1098-1101
超声乳化吸除联合人工晶体植入术治疗白内障的疗效及术后前房渗出的影响因素分析
Efficacy of Phacoemulsification Combined with Intraocular Lens Implantation in the Treatment of Cataract and Analysis of Influencing Factors of Postoperative Anterior Chamber Exudation
投稿时间:2021-08-05  修订日期:2021-08-28
DOI:10.13241/j.cnki.pmb.2022.06.021
中文关键词: 超声乳化吸除  人工晶体植入术  白内障  疗效  术后前房渗出  影响因素
英文关键词: Phacoemulsification  Intraocular lens implantation  Cataract  Efficacy  Postoperative anterior chamber exudation  Influence factor
基金项目:湖南省教育厅创新平台开放基金项目(16K065)
作者单位E-mail
谢梅傲 湖南省中医药高等专科学校附属第一医院/湖南省直中医医院眼科 湖南 株洲 412000 xma617@163.com 
代 敏 湖南省中医药高等专科学校附属第一医院/湖南省直中医医院眼科 湖南 株洲 412000  
王 英 湖南中医药大学第一附属医院眼科 湖南 长沙 410021  
李用真 湖南省中医药高等专科学校附属第一医院/湖南省直中医医院眼科 湖南 株洲 412000  
黄学思 湖南省中医药高等专科学校附属第一医院/湖南省直中医医院眼科 湖南 株洲 412000  
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中文摘要:
      摘要 目的:观察超声乳化吸除(PE)联合人工晶体植入术(IOL)治疗白内障的疗效,并分析术后前房渗出的影响因素。方法:回顾性分析我院2018年1月~2021年2月收治的行PE联合IOL治疗的白内障患者406例(482眼)的临床资料,观察其视力变化情况及术后并发症发生情况。通过单因素及多因素Logistic回归分析术后前房渗出的影响因素。结果:白内障患者术后视力0.6~0.9、≥1.0眼数占比高于术前(P<0.05)。白内障患者术后发生并发症46眼,分别为晶状体色素沉着、后囊浑浊、角膜水肿各3眼,纤维性渗出膜2眼,术后前房渗出35眼,并发症发生率为9.54%(46/482)。单因素分析结果显示:PE联合IOL术后前房渗出与高血压病史、高度近视、合并青光眼、术前眼内压>21 mmHg、术中晶状体后囊膜破裂、葡萄膜炎、术中瞳孔直径<3 mm、晶状体核分级≥IV级有关(P<0.05)。多因素Logistic回归分析结果显示:术前眼内压>21 mmHg、合并青光眼、高度近视、术中晶状体后囊膜破裂、葡萄膜炎、晶状体核分级≥IV级是术后前房渗出的影响因素(P<0.05)。结论:PE联合IOL治疗白内障,疗效较好,可有效改善患者视力,且并发症发生率较低。患者术后前房渗出受多种因素影响,临床工作中应根据相关因素制定干预、治疗措施以降低术后前房渗出风险。
英文摘要:
      ABSTRACT Objective: To observe the efficacy of phacoemulsification (PE) combined with intraocular lens implantation (IOL) in the treatment of cataract, and to analyze the influencing factors of postoperative anterior chamber exudation. Methods: 406 cases (482 eyes) of cataract patients who were treated with PE combined with IOL in our hospital from January 2018 to February 2021 were retrospectively analyzed. The changes of visual acuity and postoperative complications were observed. The influencing factors of postoperative anterior chamber exudation were analyzed by univariate and multivariate Logistic regression. Results: The proportion of postoperative visual acuity of 0.6~0.9 and ≥1.0 eyes in cataract patients was higher than that before operation(P<0.05). Postoperative complications occurred in 46 eyes of cataract patients, including lens pigmentation, posterior capsule opacity and corneal edema in 3 eyes, fibrous exudative membrane in 2 eyes and anterior chamber exudation in 35 eyes, respectively, with a complication rate of 9.54% (46/482). Univariate analysis showed that anterior chamber exudation after PE combined with IOL was related to hypertension history, high myopia, glaucoma, preoperative intraocular pressure > 21 mmHg, intraoperative posterior capsular rupture of crystalline body, uveitis, intraoperative pupil diameter < 3 mm and lens nucleus grade ≥ grade IV(P<0.05). Multivariate Logistic regression analysis showed that preoperative intraocular pressure > 21 mmHg, glaucoma, high myopia, intraoperative posterior capsular rupture of crystalline body, uveitis and lens nucleus grade ≥IV were the influencing factors of postoperative anterior chamber exudation(P<0.05). Conclusion: PE combined with IOL in the treatment of cataract has good curative effect, can effectively improve the visual acuity of patients, and the incidence of complications is low. Postoperative anterior chamber exudation is affected by many factors. In clinical work, intervention and treatment measures should be formulated according to relevant factors to reduce the risk of postoperative anterior chamber exudation.
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