目的:探讨既往有晶状体性视网膜脱离(RT)病史的患者白内障摘除后视网膜撕裂(RT)和视网膜脱离(RD)的发生率和预后。
方法:回顾性病例系列。
方法:用激光光凝或冷冻疗法成功治疗并随后接受白内障手术的法克眼。
方法:对2012年4月1日至2023年5月31日期间接受RTs治疗的有晶状体眼进行了回顾性回顾。排除包括白内障摘除前的玻璃体视网膜手术和白内障手术后不到6个月的随访。
方法:白内障手术后RTs和RD的发生率,以及视觉和解剖结果。
结果:在接受RTs治疗的12,109只眼中,1039只(8.6%)眼接受了白内障手术。排除后,研究了660例患者的713只眼。平均值(标准偏差,SD)白内障手术后的随访期为34.8(24.6)个月,中位随访时间为239天和246天,以达到新的RT或RD发展。白内障术后RT和RD的总诊断发生率为7.3%(52/713)(2.9%和4.3%,分别),一年发病率为5.6%(2.2%和3.4%,分别)。多变量回归分析确定年轻个体中RT/RD的风险较高(比值比[OR]1.034;95%置信区间[CI]1.004-1.065,P=0.028),男性(OR2.058;95%CI1.110-3.816,P=0.022),激光治疗和白内障手术间隔较短的患者(OR1.001;95%CI1.001-1.001,P=0.011)。在3个月时,25只眼(80.6%)实现了RD修复的单次手术解剖成功,最终重新附着率为100%。RT的中位最终logMAR视力为0.10(20/25),显示白内障手术后没有明显变化,RD为0.18(20/30),白内障手术后的严重恶化。
结论:白内障手术后一年,先前治疗过的RT患者的RT和RD诊断率相对较高,发生在18只眼睛中的近1只。在年轻人中发现了更高的风险,男性,以及初始RT治疗和白内障手术之间间隔较短的患者。RD修复取得了良好的解剖效果,但是视力下降了。
OBJECTIVE: To investigate the incidence and outcomes of retinal tear (RT) and retinal detachment (RD) after cataract extraction in patients with a history of previous phakic RT.
METHODS: Retrospective case series.
METHODS: Phakic eyes with RT that were successfully treated with laser photocoagulation or cryotherapy and subsequently underwent cataract surgery.
METHODS: A retrospective review of phakic eyes treated for RTs between April 1, 2012 and May 31, 2023 was performed. Exclusions included prior vitreoretinal surgery before cataract removal and follow-up of less than 6 months post-cataract surgery.
METHODS: The incidence of RTs and RDs after cataract surgery, along with visual and anatomic outcomes.
RESULTS: Of 12,109 phakic eyes treated for RTs, 1039 (8.6%) eyes underwent cataract surgery. After exclusions, 713 eyes of 660 patients were studied. The mean (standard deviation, SD) follow-up period post-cataract surgery was 34.8 (24.6) months with a median of 239 and 246 days to a new RT or RD development. The overall incidence for diagnosis of post-cataract surgery RT and RD was 7.3% (52/713) (2.9% and 4.3%, respectively), with a one-year incidence of 5.6% (2.2% and 3.4%, respectively). Multivariable regression analysis identified a higher risk of RT/RD among younger individuals (odds ratio [OR] 1.034; 95% confidence interval [CI] 1.004-1.065, P=0.028), males (OR 2.058; 95% CI 1.110-3.816, P=0.022), and those with shorter interval between laser treatment and cataract surgery (OR 1.001; 95% CI 1.001-1.001, P=0.011). Single surgery anatomic success for the RD repair was achieved in 25 eyes (80.6%) at 3 months, with a 100% final reattachment rate. The median final logMAR visual acuity was 0.10 (20/25) for RT, showing no significant change from post-cataract surgery, and 0.18 (20/30) for RD, a significant worsening from after cataract surgery.
CONCLUSIONS: One year post-cataract surgery, the rate of diagnosed RT and RD in patients with previously treated RTs was relatively high, occurring in nearly 1 in 18 eyes. Higher risk was noted among younger individuals, males, and patients with a shorter interval between initial treatment for RT and cataract surgery. RD repair achieved good anatomical results, but vision declined.