METHODS: Medical records of 924 eyes undergoing phacoemulsification were analyzed retrospectively.
METHODS: Routine cataract surgeries with or without LCD were included. Any LCD other than routine anterior capsulorhexis was defined as LCD and classified according to location and etiology. Odds ratios (OR) were calculated for maintaining vision, implantation of an artificial intraocular lens (IOL), and enucleation.
RESULTS: In total, 520 eyes were included. A LCD occurred in 145 eyes (27.8%; 145/520) and affected the posterior (85.5%; 124/145), anterior (6.2%; 9/145), and equatorial lens capsule (4.8%; 7/145) and at multiple locations (3.4%; 5/145). The etiology of the LCD was spontaneous preoperative in 41 eyes (28.3%; 41/145), accidental intraoperative in 57 eyes (39.3%; 57/145), and planned in 47 eyes (32.4%; 47/145). Disruption did not increase the odds of enucleation (OR = 1.48, 95% confidence interval [CI] 0.56-3.67; p = .36). The presence of LCD significantly increased the risk of losing vision 1 year post-operatively (OR = 8.17, 95% CI 1.41-84.93; p = .007) associated with retinal detachment. However, this was not present at 2 years follow-up or in PCCC cases at any time point. An IOL was implanted in 108 eyes (108/145; 75.2%) with LCD and in 45/47 (95.7%) eyes with a PCCC.
CONCLUSIONS: Increased surgeon awareness of possible intraoperative, accidental LCDs is important, as LCDs were relatively common and associated with increased odds for vision loss after 1 year in the present study. A prospective study investigating the causes of intraoperative, accidental LCD is warranted.
方法:对924只眼行超声乳化术的病历进行回顾性分析。
方法:包括有或没有LCD的常规白内障手术。除常规前囊撕伤以外的任何LCD均定义为LCD,并根据位置和病因进行分类。计算赔率比(OR)以保持视力,人工人工晶状体(IOL)的植入,和摘除。
结果:总计,520只眼睛。LCD发生在145只眼(27.8%;145/520),影响后部(85.5%;124/145),前(6.2%;9/145),赤道晶状体囊(4.8%;7/145)和多个位置(3.4%;5/145)。41只眼(28.3%;41/145)的LCD的病因是术前自发的,术中意外57眼(39.3%;57/145),并计划在47只眼睛(32.4%;47/145)。中断不会增加摘除的几率(OR=1.48,95%置信区间[CI]0.56-3.67;p=.36)。LCD的存在显着增加了与视网膜脱离相关的术后1年视力丧失的风险(OR=8.17,95%CI1.41-84.93;p=.007)。然而,这在2年随访时或在任何时间点的PCCC病例中均未出现.在108眼(108/145;75.2%)的LCD和45/47眼(95.7%)的PCCC中植入IOL。
结论:提高外科医生对术中可能的意识,意外的LCD很重要,因为在本研究中,LCD相对常见,且与1年后视力丧失的几率增加相关.一项前瞻性研究调查术中原因,意外LCD是必要的。