Cataract Formation after Pars Plana Vitrectomy

經平坦部玻璃體切除術後白內障形成之研究

鍾欽彬(Chin-Pin Chung) ； 徐聖曜(Sheng-Yao Hsu) ； 吳文權(Wen-Chuan Wu)

《The Kaohsiung Journal of Medical Sciences》 17卷2期 (2001/02) Pp. 84-89

https://doi.org/10.6452/KJMS.200102.0084

摘要

為了研究在平坦部玻璃體切除術後，白內障形成的時間及型態，本研究蒐集33位有完整資料的病人，期間從1995年3月至2000年1月。白內障的分類根據Lens Opacities Classification System(LOCS III)。白內障的進展及追蹤時間用回歸相關來分析。此33位病人因玻璃體視網膜病變而接受玻璃體切除術，其中4位術後合併玻璃體內氣體灌注。33位接受玻璃體切除術的病人，其遠因以糖尿病及高血壓最多，其中21位（63.6%）有糖尿病，11位（33.3%）有高血壓。血內障的進行及追蹤時間有顯著相關。31位（94%）病人屬核混濁，平均形成時間為9個月；15位（46.9%）病人為皮質混濁，平均形成時間為8個月；24位（72.7%）病人為後囊混濁，平均形成時間為13.3個月。經平坦部玻璃體術後白內障的形成並不罕見，在本研究中核混濁是最常見的型態。術後玻璃體內微環境的變化，術後眼內的發炎反應，玻璃體內所灌注的氣體及病人的年紀，皆可能是玻璃體切除術後白內障形成的關鍵。由於33位病人中僅有4位術後合併玻璃體內氣體灌注，而且玻璃體切除術後白內障形成時間短又進展快，術後玻璃體內微環境的變化及術後眼內的發炎反應所扮演的角色更為重要。至於更進一步的機轉，仍屬未知，值得將來更進一步的研究。

並列摘要

To investigate the duration and pattern of cataract formation after pars plana vitrectomy, thirty-three eyes from 33 patients with complete data from March 1995 to January 2000 were collected in this study. The time and pattern of cataract formation was analyzed according to Lens Opacities Classification System III ( LOCS III ). The correlation between the mean cataract progression and follow-up time was determined by simple regression and correlation analysis. Diabetes mellitus and hypertension were the main causes of patients with vitreoretinopathy who underwent pars plana vitrectomy procedure. Twenty-one patients (63.6%) had diabetes mellitus and 11 patients (33.3%) had hypertension. Four eyes (13.8%) received intravitreal gas injection after pars plana vitrectomy. The correlation between cataract progression and follow-up time was clinically significant (p＜0.05). Thirty-one patients (94%) were nuclear cataract, the mean time of cataract formation being 9.1 months; 15 patients (46.9%) were cortical cataract, the mean time of formation being 8 months; and 24 patients (72.7%) were posterior subcapsular cataract, the mean time of formation being 13.3 months. Cataract formation after pars plana vitrectomy is not infrequent. Nuclear cataract is the most common type in this study. Vitreous microenvironmental changes, post-vitrectomy uveitis, intravitreal gas, and patient age may be the key points of cataract formation after surgery. The mechanism of longer-term effect of pars plana vitrectomy on lens status is still unknown and merits further study.

並列關鍵字

cataract ； vitrectomy