影响白内障术后视网膜脱落的独立危险因素分析

Analysis of independent risk factors for retinal detachment after cataract surgery

目的分析影响白内障术后视网膜脱落(retinal detachment,RD)的独立危险因素。方法回顾性分析2012年1月～2015年1月我院2946例(2946眼)行白内障超声乳化吸除联合人工晶体植入术患者临床资料,根据术后3年内是否发生RD分为RD组(n=28)及非RD组(n=2918),记录RD组临床特征等情况,并将两组临床资料进行统计学分析处理,利用多因素Logistic回归分析法白内障术后发生RD的危险因素。结果 RD平均发生时间(18.54±3.39)个月;平均发病至就诊时间(31.65±6.02)d;临床表现以视野黑影为主,占67.86%。两组性别、葡萄膜炎发生情况比较,差异无统计学意义(P>0.05);RD组年龄、高度近视发生率、眼外伤发生率、糖尿病性视网膜病变发生率及后囊膜破裂、人工晶体植入睫状沟、后发性白内障等并发症发生率均高于非RD组(P<0.05)。年龄较高、存在高度近视、存在眼外伤、后囊膜破裂为影响白内障术后发生RD的独立危险因素(P<0.05)。结论年龄较高、存在高度近视、存在眼外伤、术后后囊膜破裂者均能引起白内障术后RD发生,临床对存在上述影响因素的患者应予以重视。

Objective To analyze lhe independent risk factors for retinal detachment （RD） after cataract surgery. Meth- ods The clinical data of 2946 cases （2946 eyes） of patients treated with phaeoemulsifieation combined with intraoeular lens implantation in our hospital fi＇om January 2012 to January 2015 were analyzed retrospectively. According to the presence or absence of RD within 3 years after operation, the patients were divided into RD group （n=28） and non-RD group （n=2918）. The clinical features of RD group were recorded, and the clinical data of the two groups were analyzed statistically. And muhivariate logistic regression analysis was used to analyze the risk factors for RD after cataract surgery. Results The mean duration of RD was （18.54±3.39） months, and the average time fi＇om onset to visiting was （31.65±6.02） d. The clinical manifestation was dominated by dark shadows in visual field, accounting for 67.86%. There was no significant difference in the gender and the occurrence of uveitis between the two groups （P〉0.05）. The age, and incidence rates of high myopia, ocular trauma, diabetic retinopathy, posterior capsule rupture, ciliary suleus of intraoeular lens implantation and posterior capsular opaeifieation in RD group were higher than those in non-RD group（P〈0.05）. Older age, high myopia, ocular trauma and posterior capsular rupture were independent risk factors for RD after cataract surgery（P〈0.05）. Conclusion Patients with older age, high myopia, ocular trauma and posterior capsular rupture can have RD after cataract surgery. Clinical attention should be paid to patients with the above-mentioned influeneing factors.