人工晶状体眼继发视网膜脱离的临床分析

目的 回顾性总结白内障超声乳化联合人工晶状体植入术后继发视网膜脱离病例,分析其致病因素、临床特征及治疗效果.方法 选择人工晶状体眼继发视网膜脱离病例24例25只眼.其临床体征表现为晶状体后囊膜破裂、人工晶状体偏位、晶状体皮质残留、瞳孔不易散大和眼轴长等特征;视网膜脱离范围2象限至全脱离;3只眼行外路视网膜脱离手术,22只眼行玻璃体手术.结果 24只手术眼视网膜复位良好,术后矫正视力较术前明显提高,未出现严重并发症,1只眼视网膜脱离复发,再次手术并硅油填充.结论 白内障术后致玻璃体活动度增加是造成人工晶状体眼继发视网膜脱离的主要原因,高度近视、晶状体囊膜破裂、玻璃体脱出及人工晶状体偏位等是继发视网膜脱离发生的高危因素,及早明确诊断,合理的手术治疗,会取得好的效果.

Clinical analysis of retinal detachment after phacoumulsifieation cataract extraction and intraocular lens (IOL) implantation

Objective To investigate pathogenic factors, clinical features and treatment of retinal detachment (RD) after phacoumulsifieation cataract extraction and intraocular lens (IOL) implantation. Methods This retrospective review was comprised of 24 cataract patients (25 eyes) who had phacoemulsification cataract extraction and IOL implantation from February 2006 to August 2009. Posterior capsule rupture, intraocular lens deviation, residual lens cortex, axial length were manifested in these cases, which retinal detachment (RD) was from the range of two-quadrant to totally out of touch. Three eyes were treated with extra-retinal detachment surgery. Twenty-two were treated with vitrectomy. Results Twenty-four cases of the retinal detachment were recovered in anatomy. Visual acuity compared with preoperative was improved obviously. No serious complications appeared. One eye had recrudescence of retina detachment and received second surgery with the silicone oil fill. Conclusions Vitreous detachment after secondary intraocular lens secondary is the main reasons for retinal detachment, lens capsule rupture, vitreous prolapse, and intraocular lens deviation increase the incidence of retinal detachment rate. Timely surgical treatment is the good effect to the retinal detachment after phacoumulsifieation cataract extraction and intraocular lens (IOL) implantation.