白内障术后后囊膜混浊危险因素的logistic回归分析

Retrospective analyses of potential risk factors for posterior capsule opacification after cataract surgery

目的探讨白内障术后发生后囊膜混浊(PCO)的相关危险因素.方法回顾性分析550例(625只眼)白内障术后<3年的连续白内障患者的临床资料,根据PCO诊断标准分为PCO组和非PCO组,PCO组108只眼,非PCO组544只眼.运用x^2检验对相关因素进行单因素分析,有统计学意义的危险因素进行多因素logistic回归分析,筛选独立危险因素.结果单因素分析显示,PCO的相关危险因素包括年龄(手术时),糖尿病史,免疫疾病史高度近视,晶状体核硬度,术式,合并玻切,术后炎症反应和人工晶状体(IOLs)材料(均P<0.05).多因素logistic回归分析显示,手术时年龄<60岁,糖尿病史,Ⅲ-Ⅴ级核硬度,白内障囊外摘除(ECCE),合并玻切手术和植入亲水型IOL是PCO发生的独立危险因素.结论手术时年龄<60岁,糖尿病史,Ⅲ-Ⅴ级核硬度,白内障囊外摘除(ECCE),合并玻切手术以及植入亲水型IOL的白内障术后患者发生PCO的风险较大,应及时给予患者早期指导和预防性治疗,减少PCO发生的危险因素,降低PCO的发生率.

Objective To evaluate the potential risk factors of posterior capsule opacification(PCO)after cataract surgery.Methods 652 Eyes from 550 patients were enrolled in this study.All patients were diagnosed with PCO/non-PCO and had<3 years of follow-up after cataract surgery.The numbers of PCO and non-PCO were 108 eyes and 544 eyes,respectively.The factors associated with PCO were assessed using Pearson's x^2 test for univariate analyses and logistic regression for multivariate analyses.Results Statistically significant associations with PCO were found for age at the time of surgery,diabetes,immune diseases,high myopia,lens nucleus hardness,surgery type,a history of vitrectomy,ocular inflammation,and the intraocular lens(IOL)type(all P<0.05).Multivariable data analyses using logistic regression analyses of the variables showed that age at the time of surgery<60 years,diabetes,lens nucleus hardness ofⅢ-Ⅴ,extracapsular cataract extraction(ECCE),postvitrectomy,and hydrophilic IOL were significant independent risk factors associated with PCO.Conclusions Age<60 years,diabetes,lens nucleus hardnessⅢ-Ⅴ,ECCE,postvitrectomy,and a hydrophilic IOL were significantly associated with the formation of PCO.Estimation of the incidence of and risk factors for PCO should help in patients counseling and in the design of treatment protocols to reduce or prevent its development.