前段玻璃体切割术预防高度近视白内障术后视网膜脱离  

Anterior vitrectomy in prevention of retinal detachment after extracapsular cataract extraction in high myopia

作　　者：魏忠燕[1] 柯根杰[1] 袁华音[1] 

机构地区：[1]安徽医科大学医疗二系眼科,230001

出　　处：《皖南医学院学报》2003年第3期182-184,共3页Journal of Wannan Medical College

摘　　要：目的　探讨高度近视外伤性白内障现代白内障囊外摘除术后视网膜脱离的预防措施。方法　对 1998年 1月～ 2 0 0 0年 4月连续收治的高度近视 +外伤性白内障患者均行现代白内障囊外摘除术 ,其中A组发生玻璃体脱出的 2 5例患者术中均立即加行闭合式前段玻璃体切割术 ,B组发生玻璃体脱出的 4 7例患者作为对照 ,术中均未加行闭合式前段玻璃体切割术。并比较两组患者术后视网膜脱离发生率。结果　A、B两组间后囊膜破裂发生率、玻璃体脱出发生率经 χ2 检验 ,P均 >0 .0 5 ,统计学上无显著性差异。A组视网膜脱离的发生率为 0 (0 /6 5 ) ,B组视网膜脱离的发生率为 7.95 % (14 /176 ) ,A组和B组经确切概率法检验 ,P =0 .0 2 4 ,统计学上有显著性差异。结论　高度近视 +外伤性白内障患者一旦发生玻璃体脱出 ,在白内障囊外摘除术中应加行前段玻璃体切割术 ,可以降低白内障囊外摘除术后视网膜脱离的发生率 。Objective\ To evaluate precaution of retinal detachment after extracapsular cataract extraction in high myopia.Methods\ The in patients of traumatic cataract accompanied by high myopia were divided into group A and group B from January 1998 to April 2000.Group A were performed extracapsular cataract extraction (25 cases were performed closed system anterior vitrectomy immediately after prolapse of vitreous occurred) and group B (including 47 cases of prolapse of vitreous) were only performed extracapsular cataract extraction.The incidence rates of retinal detachment between two groups were compared.In accordance with the statistical analyses ,Chi square test and exact probabilities in 2×2 table were used. Results\ After the comparison between the incidence rates of posterior capsular disruption and prolapse of vitreous no significant differences between group A and group B were found (P>0.05).None of patients had retinal detachment in group A (0/65),while the incidence rate of retinal detachment in group B was 7.95% (14/176).The difference between group A and group B was significant (P=0.024).Conclusion\ If prolapse of vitreous is found in traumatic cataract patients accompanied by high myopia during extracapsular cataract extraction,anterior vitrectomy should be performed immediately.It is a safe and effective precaution,which can reduce the incidence rate of retinal detachment after extracapsular cataract extraction.

关 键 词：前段玻璃体切割术 高度近视 白内障 白内障囊外摘除术 术后 视网膜脱离 预防 

分 类 号：R778.11[医药卫生—眼科] R776.4[医药卫生—临床医学]