摘要
目的探究白内障(CAT)患者超声乳化(PHACO)联合人工晶体植入(ILI)术后上睑下垂的危险因素。方法选择2018年6月—2021年11月于我院行PHACO及ILI术的单眼CAT患者(216例,216眼)为观察对象,分析手术的临床疗效。根据术后是否发生上睑下垂,分为下垂组(54例)和非下垂组(162例),对比分析两组患者的临床资料以及手术相关指标。多因素Logistic回归分析影响术后上睑下垂发生的危险因素,建立风险评分模型,并进行模型评价。结果与术前相比,PHACO联合ILI术后CAT患者的最佳矫正视力、眼压、前房深度以及前房角开放度均显著改善(均P<0.05)。多因素Logistic回归分析结果显示,年龄≥70岁、球周麻醉、7号麻醉注射针、麻药中混含肾上腺素、术中采用上直肌牵引线、术中使用开睑器,均为术后上睑下垂发生的独立危险因素(P<0.05)。根据回归系数β予以加权赋分,采用X-tile软件获取评分截断值,风险评分模型将术后上睑下垂发生的患者分为低风险(≤81分)、中风险(>81分且≤112分)和高风险(>112分)3组人群。模型评价结果显示,该风险评分模型的区分度、准确度和有效性均较好,且安全可靠、实用性强。结论PHACO联合ILI术可有效改善CAT患者病情,年龄≥70岁、球周麻醉、7号麻醉注射针、麻药中混含肾上腺素、术中采用上直肌牵引线、术中使用开睑器,均为术后上睑下垂的独立危险因素。
Objective To explore the risk factors of ptosis in patients with cataract(CAT)after phacoemulsification(PHACO)combined with intraocular lens implantation(ILI)surgery.Methods Monocular CAT patients(216 cases,216 eyes)who underwent PHACO and ILI in our hospital from June 2018 to November 2021 were selected as the research subjects.The clinical efficacy of the surgery was analyzed.According to the occurrence of ptosis after surgery,they were divided into a ptosis group(54 cases)and a non-ptosis group(162 cases).The clinical data and surgery-related indicators of the two groups were compared and analyzed.Multivariate Logistic regression analysis was performed to analyze the risk factors for postoperative ptosis,and a risk scoring model was established to evaluate the model.Results Compared with before operation,the best corrected visual acuity,intraocular pressure,anterior chamber depth and anterior chamber angle opening of CAT patients after PHACO combined with ILI surgery were significantly improved(P<0.05).The results of multivariate Logistic regression analysis showed that age(70 years old),peribulbar anesthesia,7-gauge anesthesia injection needle,adrenalin mixed in anesthesia,the use of superior rectus traction line during operation,and the use of eyelid opener during operation were all independent risk factors for postoperative ptosis(P<0.05).Scores are weighted according to the regression coefficientβ,and X-tile software is used to obtain the score cutoff value,and the risk scoring model divides patients with postoperative ptosis into three groups:low-risk(≤81 points),intermediate-risk(>81 points) and(112 points)and high-risk groups(>112 points).The model evaluation results show that the risk scoring model has good discrimination,accuracy and validity,and is safe,reliable and practical.Conclusion PHACO combined with ILI surgery can effectively improve the condition of CAT patients.Age(70 years old),peribulbar anesthesia,7-gauge anesthesia injection needle,epinephrine mixed in anesthesia,intraoperative use of superior rectus traction line,and intraoperative use of eyelid opener are all independent risk factors for postoperative ptosis.
作者
梁悦
张丽
程月月
LIANG Yue;ZHANG Li;CHENG Yueyue(Department of Ophthalmology,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Otolaryngology,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《西部医学》
2023年第12期1826-1830,共5页
Medical Journal of West China
关键词
白内障
超声乳化
人工晶体植入
上睑下垂
危险因素
Cataract
Phacoemulsification
Intraocular lens implantation
Ptosis
Risk factors
