视网膜色素变性合并白内障手术疗效观察  

Clinical observation of the effect of surgery on retinitis pigmentosa patients with cataract

作　　者：王进达[1] 张景尚[1] 熊瑛[1] 李婧[1] 朱谷雨 何海龙 孙秀丽 万修华[1] Wang Jinda;Zhang Jingshang;Xiong Ying;Li Jing;Zhu Guyu;He Hailong;Sun Xiuli;Wan Xiuhua(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Tongren Hospital of Capital Medical University,Beijing Key Laboratory of Ophthalmology&Visual Sciences.Beijing 100005,China;Beijing Tongren Eye Center,Beijing Tongren Hospital of Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences.Beijing 100005,China)

机构地区：[1]北京市眼科研究所,北京同仁眼科中心,首都医科大学附属北京同仁医院,北京市眼科学与视觉科学重点实验室,北京100005

出　　处：《临床眼科杂志》2020年第4期330-332,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察常规白内障超声乳化手术联合人工晶状体(IOL)植入术治疗视网膜色素变性(RP)合并白内障的效果。方法收集2014年1~12月在我院就诊行手术治疗的RP合并白内障患者7例(14只眼),男性2例,女性5例,年龄35~55岁,平均年龄(42.8±6.2岁)。所有病例均行3.2 mm透明角膜切口超声乳化手术,其中6只眼行IOL+晶状体囊袋张力环(CTR)植入,8只眼行单纯IOL植入术,术后定期复查,比较手术前后最佳矫正视力(BCVA)、眼压(IOP)、角膜内皮细胞计数变化及并发症发生情况。结果手术由同一名术者完成,IOL及CTR均100%囊袋内植入,无术中并发症发生。手术前与术后6个月比较:BCVA(0.14±0.19)vs.(0.35±0.39),差异具有统计学意义(P=0.031),其中2例(4只眼)视力明显提高,1例(2只眼)轻度提高,其它无明显提高。手术前后眼压变化(P=0.066)和角膜内皮细胞计数变化(P=0.226)无统计学差异。未植入CTR病例中1例(1只眼)发生晶状体囊袋收缩综合征,于术后6个月行囊袋松解术。结论RP合并白内障超声乳化手术治疗安全可靠,术后视力提高程度与眼底病变程度相关,CTR植入有助于减少囊袋收缩导致的相关并发症。Objective To observe the effect of phacoemulsification and intraocular lens(IOL)implantation on retinitis pigmentosa(RP)patients with cataract.Methods Seven RP patients(14 eyes)with cataract treated by surgery in our hospital from January 2014 to December 2014 were included(2 males and 5 females,35~55 years old,mean 42.8 years old)Phacoemulsification with 3.2 mm clear corneal incision was performed in all the patients.IOL plus lens capsular tension ring(CTR)implantation was performed in 6 eyes,and IOL implantation was performed in 8 eyes.Regular follow-up were conducted to compare the best corrected visual acuity(BCVA),intraocular pressure(IOP),corneal endothelial cell count and surgical complication before and after the surgery.Results All surgeries were successfully completed by the same surgeon,IOL and CTR were all implanted in the capsule without complications.The BCVA at 6 months after the surgery was 0.35±0.39,which was better than the preoperative BCVA(0.14±0.19)with statistically significant difference(P=0.031).The visual acuity of 4 eyes(2 cases)significantly improved,2 eyes(1 case)slightly improved,and the others showed no significant improvement.There was no significant difference in IOP or corneal endothelial cell count(P=0.066,P=0.226,respectively)before and after the surgery.Among the cases without CTR implantation,1 case developed lens capsular contraction syndrome,and the capsular release was performed at 6 months after the surgery.Conclusions Phacoemulsification for RP patients with cataract is safe and reliable,the improvement of postoperative visual acuity is related to the severity of fundus lesions,and CTR implantation is helpful in reducing the complications caused by capsule contraction.

关 键 词：白内障 视网膜色素变性 囊袋收缩 晶状体囊袋张力环 

分 类 号：R47[医药卫生—护理学]