Abstract：
To determine the incidence of anterior vitreous detachment (AVD) and retrolental material occurrence in cataract surgery, determine the influence of surgical factors on it, and confirm the source of the material.
Affiliated Hospital of Nantong University, Jiangsu Province, China.
Prospective single-center study.
Age, sex, ocular complication, nuclear sclerosis grade, ultrasonic time, mean longitudinal power, cumulative dissipated energy (CDE), total aspiration time, and estimated fluid usage were recorded for each patient. Retrolental anatomy was observed before and during surgery using real-time optical coherence tomography integrated into a microscope. The eyes with AVD were carefully observed and recorded during illumination with an optical fiber. Retrolental material was stained using immunohistochemistry.
205 eyes from 205 patients were included in this study. Spontaneous AVD was found in 5 cases. Intraoperatively, AVD was identified in 115 eyes (56.1%). Retrolental material presence was observed in 75 eyes (36.6%). A logistic regression model showed that CDE and aspiration time had a statistically significant effect on AVD ( P < .05, 95% CI, 1.011-1.558; P < .05, 95% CI, 1.026-1.051), and CDE was positively correlated with retrolental material occurrence ( P < .05, 95% CI, 1.052-1.534). Samples from 5 cases expressed large amounts of αA- and βA-crystallins.
Spontaneous AVD is rare in phakic eyes. There was a marked increase in AVD during surgery, with retrolental material occurring in more than a third of cases. Higher CDE and longer total aspiration time were risk factors for AVD. Immunohistochemistry revealed that most of the retrolental materials were lens fragments.
Affiliated Hospital of Nantong University, Jiangsu Province, China.
Prospective single-center study.
Age, sex, ocular complication, nuclear sclerosis grade, ultrasonic time, mean longitudinal power, cumulative dissipated energy (CDE), total aspiration time, and estimated fluid usage were recorded for each patient. Retrolental anatomy was observed before and during surgery using real-time optical coherence tomography integrated into a microscope. The eyes with AVD were carefully observed and recorded during illumination with an optical fiber. Retrolental material was stained using immunohistochemistry.
205 eyes from 205 patients were included in this study. Spontaneous AVD was found in 5 cases. Intraoperatively, AVD was identified in 115 eyes (56.1%). Retrolental material presence was observed in 75 eyes (36.6%). A logistic regression model showed that CDE and aspiration time had a statistically significant effect on AVD ( P < .05, 95% CI, 1.011-1.558; P < .05, 95% CI, 1.026-1.051), and CDE was positively correlated with retrolental material occurrence ( P < .05, 95% CI, 1.052-1.534). Samples from 5 cases expressed large amounts of αA- and βA-crystallins.
Spontaneous AVD is rare in phakic eyes. There was a marked increase in AVD during surgery, with retrolental material occurring in more than a third of cases. Higher CDE and longer total aspiration time were risk factors for AVD. Immunohistochemistry revealed that most of the retrolental materials were lens fragments.
摘要：
目的：确定白内障手术中玻璃体前脱离（AVD）和后牙材料的发生率，确定手术因素对它的影响，并确认材料的来源。
方法：南通大学附属医院,江苏省,中国。
方法：这是一个前瞻性的，单中心研究。
方法：年龄，性别,眼睛状况,核硬化等级,超声波时间,平均纵向功率，累积耗散能量(CDE)，总抽吸时间，并记录每位患者的估计液体使用情况.使用集成到显微镜中的实时光学相干断层扫描在手术之前和手术期间观察后解剖学。在用光纤照明期间仔细观察和记录具有AVD的眼睛。使用免疫组织化学将后牙材料染色。
结果：本研究包括205例患者的205只眼。5例自发性AVD。术中,在115只眼中发现AVD（56.1％）。在75只眼中观察到后牙材料的存在（36.6％）。Logistic回归模型显示，CDE和误吸时间对AVD的影响有统计学意义（P<0.05，95％OR：1.011〜1.558；P<0.05，95％OR：1.026〜1.051）。CDE与后牙材料的发生呈正相关（P<0.05，95％OR：1.052～1.534）。来自五个病例的样品表达了大量的晶状体蛋白α和β蛋白。
结论：自发性AVD在有晶状体眼很少见。手术期间AVD明显增加,超过三分之一的病例出现后牙材料。较高的CDE和较长的总误吸时间是AVD的危险因素。免疫组织化学显示，大多数后牙材料是晶状体碎片。
方法：南通大学附属医院,江苏省,中国。
方法：这是一个前瞻性的，单中心研究。
方法：年龄，性别,眼睛状况,核硬化等级,超声波时间,平均纵向功率，累积耗散能量(CDE)，总抽吸时间，并记录每位患者的估计液体使用情况.使用集成到显微镜中的实时光学相干断层扫描在手术之前和手术期间观察后解剖学。在用光纤照明期间仔细观察和记录具有AVD的眼睛。使用免疫组织化学将后牙材料染色。
结果：本研究包括205例患者的205只眼。5例自发性AVD。术中,在115只眼中发现AVD（56.1％）。在75只眼中观察到后牙材料的存在（36.6％）。Logistic回归模型显示，CDE和误吸时间对AVD的影响有统计学意义（P<0.05，95％OR：1.011〜1.558；P<0.05，95％OR：1.026〜1.051）。CDE与后牙材料的发生呈正相关（P<0.05，95％OR：1.052～1.534）。来自五个病例的样品表达了大量的晶状体蛋白α和β蛋白。
结论：自发性AVD在有晶状体眼很少见。手术期间AVD明显增加,超过三分之一的病例出现后牙材料。较高的CDE和较长的总误吸时间是AVD的危险因素。免疫组织化学显示，大多数后牙材料是晶状体碎片。
