Περίληψη:
Purpose: To compare the incidence rate of posterior capsule
opacification (PCO) after phacoemulsification and standard extracapsular
cataract extraction (P/ECCE) in eyes with antecedent uveitis with the
incidence rate in eyes without any history of intraocular inflammation.
Design: Review of records of 108 eyes of 78 patients with uveitis and
122 eyes of 106 patients with no uveitis who underwent P/ECCE. Rates of
PCO were compared by the log-rank test of differences in the
Kaplan-Meier survival curves. Proportional hazards regression models
provided estimates of the relative risks of PCO among uveitic compared
to nonuveitic eyes.
Main Outcome Measures: Performance of neodymium:YAG laser posterior
capsulotomy was used as a proxy measure for the main outcome of visually
significant PCO.
Results: Study patients ranged in age from 6 to 81 years (median, 44.5
years) among those with uveitis and 27 to 96 years (median, 68.5 years)
among those without uveitis (P = 0.0001). Crude incidence rates for
visually significant PCO were 54% over a mean follow-up of 4.3 years in
uveitic cases and 40% over a mean follow-up of 3.9 years among
nonuveitic cases (P = 0.02). Estimates of PCO incidence (95% confidence
interval) in uveitic eyes derived from the Kaplan-Meier models were
38.5% (range, 28.9%-48.2%) at 1 year and 56% (range, 45.8%-66.3%)
at 3 years, and estimates among nonuveitic eyes were 11.5% (range,
6.2%-16.8%) at 1 year and 38.4% (range, 29%-47.8%) at 3 years.
These rates of PCO among patients with uveitis and those patients
without uveitis differed significantly by the log-rank test (P = 0.004).
However, after adjusting for the younger age of patients with uveitis,
the rates of PCO were no longer statistically different.
Conclusions: The apparent higher rate of PCO in patients with uveitis is
primarily due to their younger age at the time of surgery. A moderately
increased independent risk of PCO from uveitis cannot, however, be ruled
out by this study.
Συγγραφείς:
Dana, MR
Chatzistefanou, K
Schaumberg, DA
Foster, CS
