玻璃体切割术治疗人工晶状体眼视网膜脱离的结果分析

目的探寻人工晶状体眼裂孔性视网膜脱离(pseu-dophakicretinaldetachment,PRD)玻璃体切割术后视网膜再脱离和视力差的原因。方法106例PRD患者均选择玻璃体切割作为首选手术,其中术前27例未发现裂孔,26例曾行Nd:YAG激光后囊膜切开术。术后随访6~94.8月,平均20.8月。结果术后视网膜首次复位77例,29例视网膜再脱离的原因主要是视网膜新裂孔出现和增生性玻璃体视网膜病变。术后视力>0.3者63例,≤0.3者43例。视力≤0.3的主要原因是术后黄斑功能异常(13例)、黄斑前膜(8例)、黄斑水肿(3例)和视神经萎缩(3例)。结论PRD玻璃体切割术后视网膜再脱离的原因主要是新裂孔出现和增生性玻璃体视网膜病变,而视力差的主要原因是术后黄斑功能异常、黄斑前膜、黄斑水肿和视神经萎缩。

Outcomes analysis of vitrectomy for pseudophakic retinal detachment

Objective To investigate the reasons of retinal redetachment and bad visual acuity after primary vitrectomy in the treatment of pseudophakic retinal detachment(PRD).Methods Vitrectomy was applied as the initial surgery in 106 cases with PRD,in which 26 cases had a history of posterior capsulotomy by Nd:YAG and 27 cases had no retinal breaks detected.The follow-up time postoperatively was from 6 months to 94.8 months(means 20.8 manths).Results Retinal reattachment was achieved in 77 cases.The main causes of 29 cases with retinal redetachment were new retinal breaks and proliferative vitreoretinopathy.Postoperative visual acuities of >0.3 was achieved in 63 cases,the main reasons of the visual acuity of 0.3 or less in 43 cases were presumed macular dysfunction (13 cases),macular pucker (8 cases),macular edema (3 cases) and optic nerve head atrophy (3 cases).Conclusion The main causes of postoperative retinal redetachment are new retinal breaks and proliferative vitreoretinopathy.The main reasons of bad visual acuity are presumed macular dysfunction,macular pucker,macular edema and optic nerve head atrophy.