Lens-iris diaphragm retropulsion syndrome during phacoemulsification in vitrectomized eyes

摘要

Purpose To assess the incidence and associations of lens-iris diaphragm retropulsion syndrome (LIDRS) during phacoemulsification in patients who have had vitrectomy. Setting Sunderland Eye Infirmary, Sunderland, United Kingdom. Design Case series. Methods The LIDRS was categorized into none, mild, and moderate/severe. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of increased LIDRS severity were estimated. Results Of the 75 eyes (75 patients) included, 35 (46.7%) had no LIDRS and 40 (53.3%) had LIDRS. The odds of increased LIDRS severity decreased significantly with age (OR = 0.92; 95% CI, 0.88-0.97) (P=.001) and increased with increasing axial length (AL) (OR = 3.26; 95% CI, 2.04-5.20) (P<.001) and anterior chamber depth (OR = 6.90; 95% CI, 2.00-23.8) (P=.002). The odds were greater in extensive vitrectomy than in limited vitrectomy (OR = 4.40; 95% CI, 1.64-11.84) (P=.003) and in men than in women (OR = 3.39; 95% CI, 1.40-8.23) (P=.007). The adjusted odds of increased LIDRS severity were significantly greater in extensive vitrectomy than in limited vitrectomy (adjusted OR = 4.42; 95% CI, 1.19-16.45) (P=.027) and with increasing AL (adjusted OR = 3.05; 95% CI, 1.86-5.01) (P<.001). Conclusions Lens-iris diaphragm retropulsion syndrome occurred frequently in eyes with previous vitrectomy. Several identifiable factors had a significant association with the occurrence of LIDRS, and these could be used to help in the preoperative counseling of patients and in surgical planning. Financial Disclosure Dr. Steel has attended advisory board meetings for Alcon Laboratories, Inc., Novartis Corp., and Thrombogenics NV. No other author has a financial or proprietary interest in any material or method mentioned.