超声乳化白内障吸除联合IOL植入术后前房渗出发生率及相关因素分析

Analysis of incidence and related factors on effusion of anterior chamber after phacoemulsification combined with intraocular lens implantation

目的:探讨超声乳化白内障吸除术(PE)联合人工晶状体(IOL)植入术后前房(AC)渗出发生率及相关因素的分析。方法:本研究纳入白内障患者359例375眼,其中行PE联合IOL植入术后未出现AC渗出的患者338例353眼为对照组,术后出现AC渗出的患者21例22眼为研究组。统计分析术后AC渗出发生率,并采用单因素分析法及多因素Logistic回归分析法筛选术后发生AC渗出的危险因素。结果:本研究纳入白内障患者359例375眼,行PE联合IOL植入术后AC渗出发生率为5.9%(22/375)。研究组术前眼压(IOP)、手术前后视力、核分级、术中晶状体后囊膜破裂(PCR)发生率及超声累积能量复合参数(AECP)分别与对照组比较,差异均有统计学意义(P<0.05)。单因素分析结果显示,高度近视、青光眼、葡萄膜炎、术前视力<1、术中发生PCR、术前IOP>21mmHg、术中瞳孔直径<3mm、超声AECP>7.25(%×min)、晶状体核分级≥Ⅳ级均是白内障患者行PE联合IOL植入术后出现AC渗出的危险因素(P<0.05)。多因素Logistic回归分析结果显示,高度近视、青光眼、葡萄膜炎、晶状体核分级≥Ⅳ级、术中发生PCR、术前IOP>21mmHg、超声AECP>7.25(%×min)均是白内障患者行PE联合IOL植入术后出现AC渗出的独立危险因素(P<0.05)。结论:综上所述,本研究表明高度近视、青光眼、葡萄膜炎、晶状体核分级≥Ⅳ级、术中发生PCR、术前IOP>21mmHg、超声AECP>7.25(%×min)是白内障患者行PE联合IOL植入术后出现AC渗出的独立危险因素,临床中应对具备此类危险因素的白内障患者进行密切重视,及时诊治。

AIM： To investigate the incidence and related factors on effusion of anterior chamber（AC）after phacoemulsification（PE）combined with intraocular lens（IOL）implantation.METHODS： Totally 359 cases of cataract（375 eyes）underwent PE combined with IOL implantation were collected in our hospital. The incidence of AC exudation after operation and related factors were analyzed by single factor and multiple logistic regression analysis. RESULTS： The group was included in 359 cases（375 eyes）. The incidence of postoperative AC exudation in the study group was 5.9%（22/375）. The preoperative intraocular pressure（IOP）, visual acuity before and after surgery, nuclear grades, posterior capsular rupture（PCR）rate and ultrasonic accumulated energy complex parameter（AECP）of the study group showed statistically significant difference compared with the control group（all P〈0.05）. The results of univariate factor analysis showed that high myopia, glaucoma, uveitis, preoperative visual acuity 〈1, the incidence of intraoperative PCR, preoperative IOP〉21mmHg, intraoperative pupil diameter 〈3mm, ultrasonic AECP 〉7.25（%×min）, the lens nucleus grade ≥ IV were risk factors of AC exudation after PE combined with IOL implantation in patients with cataract（all P〈0.05）. The multivariate logistic regression analysis showed that high myopia, glaucoma, uveitis, the lens nucleus grade ≥ IV, the incidence of intraoperative PCR, preoperative IOP 〉21mmHg, ultrasound AECP 〉7.25 were independent risk factors of AC exudation after PE combined with IOL implantation in patients with cataract（all P〈0.05）. CONCLUSION： High myopia, glaucoma, uveitis, the lens nucleus grade ≥ IV, the incidence of intraoperative PCR, preoperative IOP〉21mmHg, ultrasonic AECP〉7.25 are independent risk factors of AC exudation after PE combined with IOL implantation in patients with cataract, with such risk factors in patients with cataract should be paid closely attention and timely diagnosis and treatment in clinic.