在玻璃体切割术中保留前囊膜的临床观察  

Clinical observation on preservation of lens anterior capsule in vitrectomy and lensectomy

作　　者：张文一[1] 王青[1] 孟岩[1] 宋哓红[1] 孟瑞华[1] 

机构地区：[1]青岛大学医学院附属医院眼科,青岛266003

出　　处：《中国实用眼科杂志》2007年第3期303-305,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价玻璃体手术中保留前囊膜的临床效果。方法选取2002年4月～2006年4月在我院行保留前囊膜的玻璃体晶状体联合切割手术治疗视网膜脱离患者36例,其中裂孔源性视网膜脱离患者17例,糖尿病性视网膜病变（VI期）患者19例。术中眼内注气者21例,硅油填充者15例。术后追踪观察至少3个月,根据其术前、术后的视力及并发症对手术效果做出评价。结果随访期间均发生不同程度前囊膜混浊、但不影响术后眼底的观察。所有患者术后视力均高于术前或与术前相等。其中16例患者二期植入后房型人工晶体。36例患者中1例发生视网膜脱离复发,1例硅油滴进入前房,未发生角膜失代偿、青光眼等并发症。结论完整保留前囊膜可以避免复杂性视网膜脱离患者术中和术后由于眼内注气或硅油填充而产生的并发症,并有利于PCIOL的植入,可以保留虹膜的正常形态,是一种理想的手术方式。Objective To evaluate clinical effect of vitrectomy combined with lensectomy preserving anterior lens capsule. Methods Pars plana vitrectomy （PPV） and lensectomy （PPL） with preservation of the anterior capsule was performed from April 2002 to April 2006 in 36 cases （36 eyes） of retinal detachment. 17 eyes were rhegmatogenous retinal detachment and 19 eyes were diabetic retinopathy.21 eyes had gas and 15 eyes had silicone oil tamponade.Follow up at least 3 months and evaluate the surgery according to the visual acuity and the postoperative complications. Results Final visual acuity was better or equal to preoperative acuity in all eyes, improving by 3± 3 lines overall.All eyes had complete retinal reattachment at the final visit （1 eye had retinal redetachment only）. 16 eyes had been implanted PCIOL successfully at the time of 3 months after the operation.Anterior capsule opacification occurred in all eye during follow-up time but it did not influence observasion.No eyes had corneal decompensation, pupillary block, or other vision-threatening anterior segment complication. Conclusioins Vitreoretinal surgeons can preserve the anterior capsule in eyes with retinal detachment and PVR to help prevent intraoperative and postoperative complications of gas or silicone oil, simplify future PCIOL placement, and maintain a normal iris appearance.

关 键 词：玻璃体切割术 视网膜脱离/PVR 前囊膜 

分 类 号：R779.6[医药卫生—眼科]