超声乳化联合玻璃体切除术治疗白内障伴变性近视黄斑劈裂的效果  

Efficacy of phacoemulsification combined with vitrectomy for macular retinoschisis in degenerative myopic cataract eyes

作　　者：李月礼 张清生 Li Yueli;Zhang Qingsheng(Puyang Municipal Eye Hospital,the Second People’s Hospital of Puyang,Henan 457000,China)

机构地区：[1]濮阳市眼科医院,濮阳市第二人民医院,河南475000

出　　处：《中华眼外伤职业眼病杂志》2020年第1期50-53,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评估晶状体超声乳化联合玻璃体切除术治疗白内障伴变性近视黄斑劈裂的临床效果。方法回顾性分析濮阳市眼科医院2017年2月至2018年1月白内障伴变性近视黄斑劈裂36例(36眼),其中单纯行晶状体超声乳化术者16例(16眼)为超乳组,晶状体超声乳化联合玻璃体手术治疗者20例(20眼)为联合组。比较术后两组BCVA、黄斑中心区视网膜厚度以及黄斑形态。结果术前和术后3个月、6个月BCVA(logMAR)联合组分别为1.12±0.20、0.77±0.22、和0.36±0.17;而超乳组分别为1.11±0.19、0.60±0.20和0.51±0.18。术后3个月BCVA超声乳化组优于联合组,而术后6个月联合组优于超乳组,差异均有统计学意义(t=2.397,-2.563,P=0.022,0.015)。术后3个月、6个月,联合组黄斑中心区视网膜平均厚度均低于超声乳化组,差异有统计学意义(t=-2.219,-2.382;P=0.033,0.023);而两组黄斑好转率差异均无统计学意义(χ2=3.378,P=0.066)。术中未见医源性裂孔形成,术后均未发生眼内炎、眼内出血等严重并发症。结论晶状体超声乳化联合玻璃体切除术有助于改善白内障伴变性近视黄斑劈裂患者视功能。Objective To evaluate the clinical efficacy of phacoemulsification combined with vitrectomy for macular retinoschisis in degenerative myopic cataract eyes.Methods A retrospective study.Thirty-six eyes of 36 patients with macular retinoschisis in degenerative myopic cataract eyes from Feb.2017 to Jan.2018 in Puyang Municipal Eye Hospital were divided into two groups.Group A,16 eyes of 16 cases,were treated with phacoemulsification.Group B,20 eyes of 20 cases,were treated with phacoemulsification combined with vitrectomy.The BCVA,macular foveal retinal thickness and macular morphology after operation were compared between the two groups.Results The BCVA of the group B were 1.12±0.20,0.77±0.22 and 0.36±0.17 before,3 and 6 months after operation,and that of the group A were 1.11±0.19,0.60±0.20 and 0.51±0.18,respectively.The BCVA of group A at 3 months after operation was better than that of group B,but BCVA was lower than that of combined group at 6 months after operation,and the differences were statistically significant(t=2.397,-2.563,P=0.022,0.015).The average thickness of macular centre retina in group B was lower than that of group A at 3 and 6 months postoperatively(t=-2.219,-2.382;P=0.033,0.023).There was no significant difference in macular improvement rate between the two groups(χ2=0.013,P=0.909).No postoperative complication such as iatrogenic retinal breaks formation endophthalmitis or intraocular hemorrhage occurred.Conclusion Phacoemulsification combined with vitrectomy can help to improve the visual function of macular retinoschisis in degenerative myopic cataract eyes.

关 键 词：劈裂 黄斑 近视 变性 玻璃体切除术 超声乳化术 视功能 

分 类 号：R77[医药卫生—眼科]