背景:白内障超声乳化术的手术参数可以显着影响前透明膜(AHM)的行为。方法:在这项前瞻性研究中,前节光学相干断层扫描用于检查82眼超声乳化术前和术后1年的AHM的附着或脱离。撕囊尺寸的影响,水分离的数量,核硬化等级,累积耗散能量(CDE),超声波时间,总手术时间,带状纤维的弱点,Berger空间中存在透镜材料(LM-BS),和流体使用与AHM行为的关系进行了调查。结果:在所有术后时间,在存在小带无力和高CDE的情况下,观察到前玻璃体脱离(AVD)的显着线性趋势(分别为p≤0.024和p≤0.005)。同样,在1个月时观察到AVD,3个月,在高核硬化等级(p≤0.044)和高液体使用率(p≤0.021)的情况下进行1年随访。随着带状无力值的增加,LM-BS组中观察到显着的相关性(OR:0.085;95%CI:0.017至0.420;p=0.002),液体使用量也显著较高(OR:1.049;95%CI:1.003-1.096;p=0.037)。结论:带状无力,高CDE,一个坚硬的核,和大量液体使用是术后AVD的危险因素。
Background: The surgical parameters of phacoemulsification can significantly impact the behavior of the anterior hyaloid membrane (AHM). Methods: In this prospective study, anterior segment optical coherence tomography was used to examine the attachment or detachment of the AHM of 82 eyes after uneventful phacoemulsification preoperatively and postoperatively over 1 year. The impacts of the capsulorhexis\' size, number of hydrodissections, nuclear sclerosis grade, cumulative dissipated energy (CDE), ultrasonic time, total surgical time, weakness of zonular fibers, presence of lens materials in Berger\'s space (LM-BS), and fluid usage were investigated in relation to the behavior of the AHM. Results: A significant linear trend regarding anterior vitreous detachment (AVD) was observed in the presence of zonular weakness and high CDE at all postoperative times (p ≤ 0.024 and p ≤ 0.005, respectively). Similarly, AVD was observed at 1-month, 3-month, and 1-year follow-ups in cases of high nuclear sclerosis grades (p ≤ 0.044) and high fluid usage (p ≤ 0.021). A significant correlation was observed in the group of LM-BS as the zonular weakness value increased (OR: 0.085; 95% CI: 0.017 to 0.420; p = 0.002), and the fluid usage was also significantly higher (OR: 1.049; 95% CI: 1.003-1.096; p = 0.037). Conclusions: Zonular weakness, high CDE, a hard nucleus, and high fluid usage are risk factors for postoperative AVD.