慢性肾功能衰竭合并白内障患者超声乳化联合人工晶体植入术后早期低视力的多因素分析

Multivariate analysis of early low vision after phacoemulsification combined with intraocular lens implantation in patients with chronic renal failure and cataract

目的探讨影响慢性肾功能衰竭合并白内障患者行超声乳化联合人工晶体植入术后早期低视力的相关因素。方法选取2012年1月至2021年12月华南理工大学附属第六医院眼科收治的行白内障超声乳化联合人工晶体植入术的51例慢性肾功能衰竭合并白内障患者(共66眼)作为研究对象。按术后1周最佳矫正视力分为低视力组(<0.3)和对照组(≥0.3),比较两组患者年龄、性别、是否合并其他眼病、是否合并糖尿病、收缩压、舒张压、血红蛋白(Hb)、血肌酐(Cr)、术前视力、晶状体核硬度和角膜水肿程度,并进行多因素分析。结果单因素分析结果显示,两组患者的血Cr、合并其他眼病、合并糖尿病及术后角膜水肿程度比较,差异有统计学意义(P<0.05)。多因素分析结果显示,术前合并其他眼病(β=1.684,OR=6.910,95%CI=1.548~21.742)、术后角膜2~4级水肿(β=1.622,OR=4.709,95%CI=1.309~9.644)是导致术后早期低视力的独立危险因素(P<0.05)。结论慢性肾功能衰竭合并白内障超声乳化联合人工晶体植入术后早期低视力的影响因素较多,合并其他眼病、术后角膜2~4级水肿是导致术后早期低视力的独立危险因素。

Objective To explore the related factors of early low vision after phacoemulsification combined with intraocular lens implantation in patients with chronic renal failure(CRF)and cataract.Methods A total of 51 cases of patients(66 eyes)with CRF and cataract who underwent phacoemulsification combined with intraocular lens implantation from January 2012 to December 2021 in Department of Ophthalmolgy,the Sixth Affiliated Hospital of South China University of Technology were selected as research objects.They were divided into low vision group(<0.3)and control group(≥0.3)according to the best corrected visual acuity 1 week after operation.Compare the age,gender,whether combined with other eye diseases,whether combined with diabetes,systolic blood pressure(SBP),diastolic blood pressure(DBP),hemoglobin(Hb),serum creatinine(Cr),preoperative visual acuity,lens nucleus hardness and postoperative corneal edema degree of two groups,and perform a multivariate analysis.Results Univariate analysis showed that there were statistically significant differences in serum Cr,combined with other eye diseases,combined with diabetes and postoperative corneal edema degree between the two groups(P<0.05).Logistic multivariate analysis showed that combined with other eye diseases before operation(β=1.684,OR=6.910,95%CI=1.548-21.742)and corneal edema of grade 2-4(β=1.622,OR=4.709,95%CI=1.309-9.644)were independent risk factors for early low vision after operation(P<0.05).Conclusion There are many influencing factors of early low vision after phacoemulsification combined with intraocular lens implantation in CRF combined with cataract.Combined with other eye diseases and corneal edema of grade 2-4 are independent risk factors of early postoperative low vision.