Impact of vitrectomy and air tamponade on aspheric intraocular lens tilt and decentration and ocular higher-order aberrations: phacovitrectomy versus cataract surgery
Impact of vitrectomy and air tamponade on aspheric intraocular lens tilt and decentration and ocular higher-order aberrations: phacovitrectomy versus cataract surgery
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DOI：
10.1007/s10384-020-00737-0
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发表时间：
2020-07-01
影响因子：
2.4
通讯作者：
Emi, Kazuyuki
中科院分区：
文献类型：
--
作者：
Iwama, Yasuaki;Maeda, Naoyuki;Emi, Kazuyuki
目的评价玻璃体切割联合空气填充对白内障联合玻璃体切割手术（超声乳化玻璃体切割术）非球面人工透镜（IOL）倾斜、偏心及术后内部高阶像差（HOA）的影响。研究设计：前瞻性比较观察研究。方法对45眼行超声乳化玻璃体切割术联合非球面人工晶状体植入术和18眼单纯白内障手术联合非球面人工晶状体植入术进行前瞻性研究。受试者被分为三组：无液体-空气交换（F/Ax）的晶状体玻璃体切除术或F/Ax和单独的白内障手术（分别为A、B和C组）。比较每对组之间手术引起的透镜倾斜和偏心以及内部HOA的变化。对术后1个月IOL严重倾斜（> 7度）或偏心（> 0.40 mm）的病例进行亚组分析。结果术后1周、1个月和3个月B组透镜倾斜度的变化明显大于C组（P值分别为0.007、0.009和0.043），而透镜偏心度的变化各组间无显著性差异。B组的人工晶状体向鼻下方向倾斜并偏心。相比之下，在任何术后访视时，各组之间的内部HOA均无显著差异。只有B组包括IOL大部分偏心的病例，这些病例的内部总HOA显著大于其他病例（P= 0.015）。结论虽然B组中偶尔会出现严重偏心的人工晶状体，但非球面人工晶状体可以有效地用于超声乳化玻璃体切割术。
Purpose To evaluate the impact of vitrectomy and air tamponade on aspheric intraocular lens (IOL) tilt and decentration and postoperative internal higher-order aberrations (HOAs) in combined cataract surgery and vitrectomy (phacovitrectomy). Study design Prospective comparative observational study. Methods Forty-five eyes that underwent phacovitrectomy using aspheric IOLs and 18 eyes that only underwent cataract surgery also using aspheric IOLs were prospectively evaluated. The subjects were divided into three groups: phacovitrectomy without fluid-air exchange (F/Ax) or with F/Ax and cataract surgery alone (Groups A, B, and C, respectively) Surgery-induced changes in lens tilt and decentration and internal HOAs were compared between each pair of groups. Subgroup analysis was conducted for cases with largely tilted (> 7 degrees) or decentered (> 0.40 mm) IOLs 1 month postoperatively. Results Surgery-induced changes in lens tilt in Group B were significantly more pronounced than those in Group C at 1 week, 1 month, and 3 months postoperatively (P= 0.007, 0.009, and 0.043, respectively), while there was no significant difference in surgery-induced changes in lens decentration among the groups. IOLs in Group B were tilted and decentered toward the inferonasal direction. In contrast, there was no significant difference in internal HOAs among the groups at any postoperative visit. Only Group B included cases with largely decentered IOLs, and the internal total HOAs in these cases were significantly larger than those in the others (P= 0.015). Conclusion Although largely decentered IOLs were occasionally found in Group B, aspheric IOLs could be effectively used in phacovitrectomy.