白内障超声乳化联合IOL植入术后并发CCS的危险因素分析

Risk factors of capsular contraction syndrome after phacoemulsification combined with intraocular lens implantation

目的分析白内障超声乳化联合人工晶体(IOL)植入术后并发囊袋收缩综合征(CCS)的危险因素。方法选择2020年1月至2020年12月在宝鸡市人民医院眼科接受白内障超声乳化联合IOL植入术的100例患者展开研究,根据患者术后3个月CCS的发生情况分为CCS组7例,无CCS组93例。比较两组患者术前及术后3个月的最佳矫正视力(BCVA)、对比敏感度(CSF),并对影响白内障超声乳化联合IOL植入术后并发CCS的原因进行单因素分析和多因素Logistic回归分析。结果CCS组患者术前BCVA以及CSF 1.5c/d、6c/d、18c/d分别为(0.48±0.07)LogMAR、1.45±0.13、1.06±0.14、0.05±0.01,明显低于无CCS组的(0.57±0.11)LogMAR、1.59±0.16、1.22±0.16、0.07±0.02,CCS组患者术后3个月时,BCVA以及CSF 1.5c/d、6c/d、18c/d分别为(0.69±0.08)LogMAR、1.68±0.17、1.48±0.16、0.21±0.03,明显低于无CCS组的(0.83±0.07)LogMAR、1.87±0.15、1.76±0.18、0.35±0.05,差异均有统计学意义(P<0.05);经单因素分析结果显示,两组患者的年龄以及有无糖尿病、青光眼、葡萄膜炎、高度近视、视网膜色素变性、IOL植入材料比较差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,年龄、糖尿病、青光眼、葡萄膜炎、高度近视、视网膜色素变性、IOL植入材料均是导致白内障超声乳化联合IOL植入术后并发CCS的危险因素(P<0.05)。结论白内障超声乳化联合IOL植入术后并发CCS的危险因素包括年龄、糖尿病、青光眼、葡萄膜炎、高度近视、视网膜色素变性、IOL植入材料,临床上可根据上述危险因素早期干预,以期减少CCS的发生。

Objective To analyze the risk factors of capsular contraction syndrome(CCS)after phacoemulsification combined with intraocular lens(IOL)implantation.Methods A total of 100 patients who received phacoemulsification combined with IOL implantation in Department of Ophthalmology,Baoji People's Hospital from January 2020 to December 2020 were selected for the study.According to the occurrence of CCS 3 months after surgery,the patients were divided into the CCS group(n=7)and non-CCS group(n=93).The best corrected visual acuity(BCVA)and contrast sensitivity(CSF)were compared between the two groups before and 3 months after surgery.Univariate analysis and multivariate Logistic regression analysis were performed to determine the causes of CCS after phacoemulsification combined with IOL implantation.Results The preoperative BCVA and CSF 1.5c/d,6c/d and 18c/d in the CCS group were(0.48±0.07)LogMAR,1.45±0.13,1.06±0.14,and 0.05±0.01,which were significantly lower than(0.57±0.11)LogMAR,1.59±0.16,1.22±0.16,0.07±0.02 in the non-CCS group,while the BCVA and CSF 1.5c/d,6c/d,18c/d at 3 months after surgery were(0.69±0.08)LogMAR,1.68±0.17,1.48±0.16,0.21±0.03,significantly lower than(0.83±0.07)LogMAR,1.87±0.15,1.76±0.18,0.35±0.05 in the non-CCS group(P<0.05).Univariate analysis results showed that there were significant differences in age,diabetes,glaucoma,uveitis,high myopia,retinitis pigmentosa,and IOL implant materials between the two groups(P<0.05).Multivariate Logistic regression analysis results showed that age,diabetes,glaucoma,uveitis,high myopia,retinitis pigmentosa,and IOL implant materials were all risk factors for CCS after phacoemulsification combined with IOL implantation(P<0.05).Conclusion Risk factors for CCS after phacoemulsification combined with IOL implantation include age,diabetes,glaucoma,uveitis,high myopia,retinitis pigmentosa,and IOL implant materials,which can be clinically intervened in early stage,in order to reduce the occurrence of CCS.