巩膜扣带术联合超声乳化治疗孔源性视网膜脱离合并白内障  

Clinical observation of combined scleral buckling surgery and phacoemulsification for rhegmentogenous retinal detachment and cataract

作　　者：段欣荣[1] 朱晓青[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华眼外伤职业眼病杂志》2012年第6期420-423,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨巩膜扣带术联合晶状体超声乳化治疗孔源性视网膜脱离合并白内障的手术操作技巧及其效果。方法回顾性分析巩膜扣带术联合晶状体超声乳化治疗的孔源性视网膜脱离合并自内障29例（29眼）其中同期后房型人工晶状体植入25眼。术中联合玻璃体腔注入六氟乙烷（C2F6）8眼，注入滤过空气1眼。手术后随访3～24个月。对视力、人工晶状体位置、视网膜复位情况及手术并发症等进行了临床观察。结果所有病例术中眼底检查满意，均发现裂孔。随访期末视力提高者22跟，占75．86％（其中提高2行以上者16眼占55．17％）；视力不变者7眼，占24。14％。随访期内28眼视网膜完全复位（96．55％），1眼视网膜未完全复位（3．45％）。所有病例人工晶状体无明显偏位，术中术后无严重并发症发生。结论巩膜扣带术联合晶状体超声乳化治疗孔源性视网膜脱离合并白内障既可免除患者二次手术的痛苦，又可使视网膜脱离及时复位，有助于恢复较好的视功能。Objective To report the technique and results of simultaneous scleral buckling surgery and phacoemulsification for rhegmentogenous retinal detachment and cataract. Methods Twenty-nine pa- tients （29 eyes） with rhegmentogenous retinal detachment accompanied with dense cataract were retrospec- tively investigated. All the eyes underwent a combined surgery involving scleral buckling and phacoemulsifi- cation [ 25 eyes also combined with posterior chamber intraocular lense （IOL） implantation]. Among those, 8 eyes combined with intravitreal injection of C2 F6, 1 eye with filtered air. Postoperative follow up was 3 - 24 months. The visual acuity, IOL position, retinal reattachment status and complications of the surgery were observed. Results A clear intraoperative view of the fundus was obtained in all eases and retinal breaks were identified. The best corrected visual acuity improved in 22 eyes （75. 86% ） in the last follow up, among which 16 eyes （55.17%） improved 2 or more lines, remained unchanged in 7 （24.14%） eyes. The retinae were reattached by combined surgery in 28 cases （96.55%） during the last follow up, partially reattached in 1 eye （3.45%）. There was no IOL dislocation or severe complications. Conclusion Com- bined scleral buckling and cataract surgery spare the patient from repeat surgery and may improve the visual function by avoiding delay for detachment repair.

关 键 词：巩膜扣带术 晶状体超声乳化 视网膜脱离 白内障 

分 类 号：R779.6[医药卫生—眼科]