视网膜脱离巩膜外垫压术后白内障超声乳化人工晶状体植入术的疗效

目的 评价视网膜脱离巩膜外垫压术后施行白内障超声乳化和人工晶状体植入术的术中、术后并发症和最佳矫正视力结果。方法 回顾性观察1997年11月～2002年11月施行视网膜巩膜垫压术后施行白内障超声乳化和人工晶状体植入术的患者。记录术前、术后的最佳矫正视力，术中、术后并发症。并对其临床特点进行分析和讨论。结果 48例49眼。从视网膜脱离手术到超声乳化手术之间的时间为6月～43年，平均13．5年；超声乳化手术平均随访24．6个月。术后最佳矫正视力≥0．1者43眼(87．76％)，≥1．0者25眼(51．02％)。6眼矫正视力低于0．1的患者中，5眼黄斑区有增殖条索改变，1眼存在视网膜前膜。3眼发生后发性白内障行激光晶状体后囊膜切开术。随访期内未发现视网膜再脱离者。结论 视网膜脱离巩膜外垫压术后行白内障超声乳化联合人工晶状体植入术，可使大部分患者恢复较好的视功能，手术并发症少，无视网膜脱离再复发，具有较高安全性。

Phacoemulsification and lens implantation after sceral explant and encircling surgery

Objective To determine the intraoperative and postoperative complications and best-corrected Visual acuity outcomes of eyes undergoing phacoemulsification and intraocular lens implantion after retinal detachment repair by the scleral explant and encircling surgery.Methods The charts of all patients who underwent Phacoemulsification and IOL implantation between November 1997 and November 2002 in Zhuomei Eye Center were reviewed to identify eyes with a history of rerinal detachment repaired by the scleral explant and encircling surgery.Preoperative and postoperative best-corrected visual acuity,and intraoperative and postoperative complications were recorded.Results We identified 49 eyes of 48 patients.The mean interval from retinal detachment repair to phacoemulsification was 13.5 years.The mean interval from phacoemulsification to final examination was 24.6 months.Final best-corrected visual acuity of 20/200 or better was attained in 43(87.76%) of 49 eyes and 20/20 or better in 25(51.02%) of the eyes.Of the six eyes with the lowest best-corrected visual acuity,five had a macula-off retinal detachment,one had a epiretinal membrane.With regard to complications,3 eyes required laser capsulotomy for posterior capsular opacification.No eye developed a retional redetachment.Conclusions Phacoemulsification and IOL can be performed safely after scleral explant and encircling surgery and excellent best-corrected visusl acuity results can be attained in most eyes.No retinal redetachment occurred in this series.