高度近视有晶状体眼后房型人工晶状体术后孔源性视网膜脱离的临床特征及预后分析  

Clinical presentation and outcomes of rhegmatogenous retinal detachment in phakic eyes after posterior chamber phakic intraocular lens implantation for high-myopia

作　　者：向楚琪 李凡 向武[1] 黄绍玢 江志豪 骞元婕 魏雁涛[1] 吕林[1] XIANG Chuqi;LI Fan;XIANG Wu;HUANG Shaofen;JIANG Zhihao;QIAN Yuanjie;WEI Yantao;LÜ Lin(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangdong Provincial Clinical Research Center for Ocular Diseases,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心,眼科学国家重点实验室,广东省眼科视觉科学重点实验室,广东省眼部疾病临床医学研究中心,广州510060

出　　处：《眼科学报》2022年第2期111-116,共6页Eye Science

基　　金：国家自然科学基金(3030901001204)。

摘　　要：目的:分析高度近视有晶状体眼后房型人工晶状体植入术后孔源性视网膜脱离的临床特征及预后。方法:回顾分析2012年4月至2021年6月中山眼科中心收治的9例(9只眼)行后房型人工晶状体植入术后孔源性视网膜脱离患者的临床特征、手术方式及疗效,随访(4.96±4.78)个月。结果:患者年龄(30.44±20.11)岁,屈光手术至发病时间(32.10±17.80)个月。4例(44.4%)马蹄形裂孔,1例(11.1%)萎缩性裂孔,4例(44.4%)巨大裂孔;9眼裂孔均位于赤道部前,除2眼(22.2%)为单个巨大裂孔,1眼(11.1%)单个马蹄孔,余6眼(66.7%)均有视网膜周边变性区存在;视网膜脱离范围(3.0±1.12)个象限,8例累及黄斑;增殖性玻璃体视网膜病变C级以上4眼。视网膜初始复位率为77.8%,最终视网膜复位率100%。末次随访最佳矫正视力优于术前(P<0.05)。随访期间,2例硅油填充眼发生并发性白内障,4眼发生术后早期高眼压。结论:有晶状体眼后房型人工晶状体植入术前存在的视网膜变性或术后玻璃体牵引的存在可能是孔源性视网膜脱离发生的危险因素。Objective:To analyze the clinical presentation,surgical management,and outcomes of rhegmatogenous retinal detachment(RRD)in patients with high-myopia corrected by posterior chamber phakic(PCP)intraocular lens(IOL)implantation.Methods:Nine eyes of 9 patients in whom RRD developed after PCPIOL implantation from April 2012 to June 2021 in Zhongshan Ophthalmic Center were retrospectively studied.Mean follow-up after retinal detachment surgery was(4.96±4.78)months.Results:Mean patient age was(30.44±20.11)years old.RRD occurred(32.10±17.80)months after PCPIOL implantation.Four(44.4%)breaks were horseshoe tear,1(11.1%)was atrophic hole and 4 participants(44.4%)had a giant retinal tear.Nine cases had causative breaks located anterior to the equator while peripheral retina lattice degeneration was found in 6 eyes.RRD extended from 1 to 4 quadrants(3.0±1.12 quadrants)and 8 cases were macula-off retinal detachments.Four eyes’proliferative vitreoretinopathy were more severe than level C.Initial reattachment rate was 77.80%.Final retinal reattachment was 100%.Final follow-up BCVA was significantly better than baseline(P<0.05).Furthermore,concurrent cataract occurred in 2 eyes in which silicone oil was used as tamponade.Ocular hypertension was detected in 4 eyes after surgery.Conclusion:The existed lattice degeneration and postoperative vitreous traction may be risk factors for RRD after PCPIOL implantation.

关 键 词：高度近视 有晶状体眼后房型人工晶状体 孔源性视网膜脱离 

分 类 号：R779.6[医药卫生—眼科]