老年性白内障超声乳化吸除术后早期视力低下的影响因素

Risk factors of early low vision after phacoemulsification and intraocular lens implantion in senile cataract

目的:探讨老年性白内障超声乳化吸除术联合人工晶状体植入术术后早期视力低下的影响因素。方法:行老年性白内障超声乳化吸除术联合人工晶状体植入术的患者278例310眼,采用流行病学方法对可能影响术后早期视力的术前情况、手术过程及术后眼部情况的因素进行多因素分析,筛选出术后早期视力低下的影响因素。结果:经单因素分析有统计学意义的变量9项引入多因素logistic回归,最终进入模型的变量有6项,分别为年龄(OR=1.637,95%CI:1.168～2.293)、术前矫正视力(OR=1.745,95%CI:1.169～2.605)、青光眼病史(OR=3.645,95%CI:1.537～8.645)、眼底病变(OR=5.158,95%CI:2.787～9.546)、超声乳化时间(OR=4.065,95%CI:2.264～7.298)和术后角膜水肿(OR=1.045,95%CI:1.021～1.069)。结论:年龄大、术前矫正视力差、青光眼病史及眼底病变、超声乳化时间长、术后角膜水肿是术后早期视力低下的影响因素。眼底病变和超声乳化时间长是主要影响因素。

AIM： To explore the risk factors of early low vision after phacoemulsification and intraocular lens implantion in the elderly patients with cataract. METHODS： A total of 278 cataract patients 310 eyes who underwent phacoemulsification and intraocular lens implantion were retrospectively studied. The susceptible preoperative risk factors to early low vision before the surgery, during the surgery process and ocular situation after the surgery were evaluated. The risk factors were analyzed by statistical multivariables analysis to investigate the factors which affect the early low vision. RESULTS： By univariate logistic regression analysis, it was indicated that nine factors were correlated with early low vision after surgery （P〈0.05）. By multi-variables logistic regression analysis, six factors were related to early low vision after surgery, including age（OR=1.637,95%CI：1.168-2.293）, preoperative corrected visual acuity（OR=1.745,95%CI：1169-2.605）, glaucoma（OR=3.645,95%CI：1.537-8.645）, ocular fundus abnormalities （OR=5.158,95%CI：2.787-9.546）, time of phacoemulsification（OR=4.065,95%CI：2.264-7.298）and corneal edema after surgery（OR=1.045,95%CI：1.021-1069）. CONCLUSION： Older, preoperative low corrected visual acuity, glaucoma, ocular fundus abnormalities, long time of phacoemulsification and corneal edema after surgery are risk factors affecting the early low vision after surgery. Ocular fundus abnormalities and long time of phacoemulsification are important risk factors . 