白内障超声乳化术中后囊膜破裂危险因素及预后研究

目的：通过调查本院内超声乳化吸除术治疗的白内障患者，分析术中造成后囊膜破裂相关危险性因素，并对手术预后相关情况加以评估。方法：选取2012－11／2015－11来我院治疗的1825例1912眼白内障患者。分析区间内患者中后囊膜破裂的总数以作为后囊膜破裂组。其他患者中以1∶4比例随机选取对照组。将区间内所有患者的年龄、性别、白内障类型、眼病史、其他病史、手术史、术前眼压、眼别、患者健康情况、手术前后1d的视力水平等因素进行统计，使用统计学方法对造成白内障患者术中后囊膜破裂的危险因素进行分析，探究风险及预后相关情况。结果：统计结果显示，性别、白内障类型、手术前眼压状况、烟酒史、眼别等因素对破裂率并无影响，无统计学意义（P＞0．05）；而患者核分型、术前视力水平、部分眼部疾病是导致患者后囊膜破裂相关危险因素，有统计学意义（P＜0.05）。术后两组患者的视力均有所好转，但后囊膜破裂患者的视力则显著下降。结论：患有眼部疾病史（玻璃体积血病史、视网膜脱离手术史及术前视力水平＜20／200）者在术中更易导致后囊膜破裂，白内障核分型Ⅳ及以上也是重要风险因素之一，术前要详细了解白内障患者的相关病史，对风险因素进行全面合理评估；术中谨慎将相关风险因素发生率降至最低，进而提高手术成功率，预后恢复情况得以改善。

Analysis on risk factors and prognosis of posterior capsular rupture in phacoemulsification cataract surgery

Abstract?AIM: To investigate the risk factors and prognosis of posterior capsular rupture in phacoemulsification cataract surgery through analyzing the cataract patients in our hospital.?METHODS:Totally 1825 patients (1912 eyes) treated in our hospital were selected from November 2012 to November 2015. The patients with posterior capsular rupture were as observation group.Control group was randomly selected with a 1: 4 ratio in patients without posterior capsular rupture.All the patient's age, gender, type of cataract, ocular disease history, other medical history, surgical history, preoperative intraocular pressure, the eyes affected, the health situation, visual acuity at 1d before and after surgery and other factors were recorded and analyzed for risk factors and prognosis.?RESULTS: Statistical results showed gender, type of cataract, preoperative intraocular pressure, history of tobacco and alcohol, eyes affected and other factors did not impact on the rupture rate ( P>0.05 ); and type of nucleus, preoperative visual acuity, some eye diseases were the risk factors for posterior capsule rupture ( P<0.05).Postoperative visual acuity of the two groups was all improved, but visual acuity of patients with posterior capsule rupture significantly decreased.?CONCLUSION: With eye disease history ( a history of vitreous hemorrhage, retinal detachment before surgery and preoperative visual acuity <20/200) are more likely to result in intraoperative posterior capsular rupture.Nuclear hardness over grade Ⅳ is also an important risk factor. Before one surgery, it is needed to learn more about the medical history of cataract patients, to conduct a reasonable comprehensive assessment for risk factors, to decrease the risk in the surgery, which are to increase the success rate and to improve the prognosis.