CAJ | 학술논문

目的观察白内障超声乳化吸除联合人工晶状体(IOL)植入手术后黄斑裂孔性视网膜脱离(MHRD)的发生率,并探讨影响其发生的相关因素.方法回顾性分析10 076例白内障超声乳化吸除联合IOL植入手术患者13 625只眼的临床资料,其中眼轴≥26.0 mm或植入晶状体度数≤15.0 D的高度近视白内障患者1228例1853只眼.所有患者手术前常规行裂隙灯显微镜、检眼镜及A或B型超声检查等检查.采用透明角膜切口或巩膜隧道切口行白内障超声乳化吸除联合IOL植入手术.手术后随访12～126个月,平均随访时间(48.2±31.1)个月.通过散瞳检查眼底和B型超声、光相干断层扫描(OCT)检查确诊是否发生MHRD,并对发生MHRD者相关危险因素进行分析.结果本组患者中,共有9例10只眼发生MHRD,占本组手术眼的0.073%.其中,6例7只眼为高度近视眼患者,高度近视眼MHRD的发生率为0.378%.MHRD的发生时间为手术后9～74个月,平均时间为38.5个月.累计风险度估计为0.16%(95%可信区间为0.05%～0.27%).结论白内障超声乳化吸除联合IOL植入手术后MHRD的发生率为0.073%,高度近视眼MHRD的发生率为0.378%.手术前合并高度近视可能是影响MHRD发生的危险因素,其中,近视可能与MHRD紧密相关.
목적 관찰백내장초성유화흡제연합인공정상체(IOL)식입수술후황반렬공성시망막탈리(MHRD)적발생솔,병탐토영향기발생적상관인소.방법 회고성분석10 076례백내장초성유화흡제연합IOL식입수술환자13 625지안적림상자료,기중안축≥26.0 mm혹식입정상체도수≤15.0 D적고도근시백내장환자1228례1853지안.소유환자수술전상규행렬극등현미경、검안경급A혹B형초성검사등검사.채용투명각막절구혹공막수도절구행백내장초성유화흡제연합IOL식입수술.수술후수방12～126개월,평균수방시간(48.2±31.1)개월.통과산동검사안저화B형초성、광상간단층소묘(OCT)검사학진시부발생MHRD,병대발생MHRD자상관위험인소진행분석.결과 본조환자중,공유9례10지안발생MHRD,점본조수술안적0.073%.기중,6례7지안위고도근시안환자,고도근시안MHRD적발생솔위0.378%.MHRD적발생시간위수술후9～74개월,평균시간위38.5개월.루계풍험도고계위0.16%(95%가신구간위0.05%～0.27%).결론 백내장초성유화흡제연합IOL식입수술후MHRD적발생솔위0.073%,고도근시안MHRD적발생솔위0.378%.수술전합병고도근시가능시영향MHRD발생적위험인소,기중,근시가능여MHRD긴밀상관.
Objective To observe the incidence and related factors of macula hole retinal detachment (MHRD)after phacoemulsification cataract extraction and intraocular lens(IOL) implantation. Methods The clinical data of 10 076 patients (13 625 eyes) who underwent phacoemulsification cataract extraction and intraocular lens implantation were retrospectively analyzed. There are 1228 patients (1853 eyes) with high myopia. All the patients were examined by routine slit-lamp microscopy, ophthalmoscopy as well as A-or B-scan ultrasonography. The phacoemulsification cataract extraction with transparent cornea incision or scleral tunnel incision, combined with intraocular lens implantation was performed in all the patients. The follow-up was ranged from 12 to 126 months, with a mean of (48.2±31.1) months. The MHRD was confirmed by the examinations of the fundus, B-scan ultrasonography and optical coherence tomography.The incidence of postoperative MHRD and the risk factors were analyzed. Results 10/13 625 eyes (0.073%) with MHRD were observed. 7/1853 high myopia eyes (0.378%) with MHRD were observed.The occurrence time of MHRD was ranged from 9 to 74 months after surgery, with a mean of 38.5 months.The cumulative risk was estimated at 0.16% (95% confidence interval, 0.05%-0.27%). Conclusions The incidence of MHRD after phacoemulsification cataract extraction combined with intraocular lens implantation is 0.073%. The MHRD incidence of high myopia eyes is 0.378%. High myopia may be the risk factor for MHRD.