Purpose: To determine the effect of intraocular lens (IOL) materials on visual outcomes and related complications in patients with posterior capsular (PC) rupture during phacoemulsification surgery. Methods: In this retrospective case-control study, inclusion criteria were PC rupture and primary implantation of acrylic or silicone IOL; while exclusion criteria were pre-existing ocular diseases, previous ocular surgery, intraoperative complications other than PC rupture, and follow-ups less than six months. Main measure outcomes were postoperative best corrected visual acuity (BCVA) at three time points (week 1, month 1, and month 6). Results: PC rupture occurred in 100 out of 2495 patients (4%). After exclusion of three patients, 97 were classified as acrylic (n = 47) or silicone (n = 50) groups by IOL materials, and an additional 45 without PC rupture were selected as a control group. Postoperative BCVA was not different between the acrylic IOL and control groups at all three time points, but it was worse in the silicone IOL group (P<.01). Stable BCVA was achieved one month postoperatively in the acrylic group, but not until six months in the silicone group. Corneal edema was the most common complication, followed by IOL malposition and intraocular pressure elevation. Complication rate showed no difference between the acrylic and silicone IOL groups (P=.26) but was lower in the control group (P=.03). Conclusion: For phacoemulsification patients who are complicated by PC rupture, faster recovery and better results of BCVA are achieved with acrylic than silicone IOL, while complication rates are similar.
目的:比較不同人工水晶體在於超音波乳化術期間發生後囊破裂之白內障病人,其視力預後以及併發症之差異。方法:此論文為回溯性病例控制研究,以術後一週,一個月以及六個月的術後最佳矯正視力為預後因子。 結果:共97位病人分成壓克力(47人)或矽(50人)組,而未發生後囊破裂的45人做為對照組。術後最佳矯正視力於壓克力組跟控制組間沒有差別,但矽組比前兩者差。壓克力組之術後最佳矯正視力在術後一個月即趨穩定,矽組要到術後六個月。併發症發生率在壓克力組跟矽組之間沒有差別,但控制組比前兩者低。結論:對接受超音波乳化術而合併後囊破裂的病人而言,壓克力人工水晶體比矽人工水晶體有較快的視力恢復速度以及較好的術後矯正視力,但併發症發生率相同。
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