Koenig S B, Mieler W F, Han D P, Abrams G W
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
Arch Ophthalmol. 1992 Aug;110(8):1101-4. doi: 10.1001/archopht.1992.01080200081029.
Eighteen eyes with coexisting cataract and vitreoretinal disease underwent combined phacoemulsification, pars plana vitrectomy, and posterior chamber lens implantation. Preoperative vitreoretinal disease included nonclearing vitreous hemorrhage (eight eyes), vitreous hemorrhage and tractional retinal detachment (three eyes), tractional retinal detachment (one eye), epiretinal membranes (three eyes), peripheral uveitis (two eyes), and a retained intraocular metallic foreign body (one eye). Postoperative visual acuity improved in each case; 14 eyes achieved visual acuity between 20/20 and 20/80 during an average postoperative period of 11 months (range, 3 to 39 months). Perioperative complications included an iatrogenic retinal break (one eye) and pupillary block glaucoma (one eye). Four eyes required YAG laser capsulotomy postoperatively. Phacoemulsification did not interfere with corneal clarity, allowed water-tight wound closure during vitrectomy, and preserved the capsular bag, allowing endocapsular fixation of the posterior chamber lens. Combining phacoemulsification, posterior chamber lens implantation, and pars plana vitrectomy allows rapid visual rehabilitation and functional unaided vision in these eyes.
18例患有白内障合并玻璃体视网膜疾病的患者接受了白内障超声乳化吸除术、玻璃体切除术和平坦部玻璃体切除术及后房型人工晶状体植入术。术前玻璃体视网膜疾病包括玻璃体积血不吸收（8例）、玻璃体积血合并牵拉性视网膜脱离（3例）、牵拉性视网膜脱离（1例）、视网膜前膜（3例）、周边葡萄膜炎（2例）和眼内金属异物残留（1例）。所有患者术后视力均有改善；14例患者在术后平均11个月（范围3至39个月）时视力达到20/20至20/80。围手术期并发症包括医源性视网膜裂孔（1例）和瞳孔阻滞性青光眼（1例）。4例患者术后需要YAG激光晶状体后囊切开术。白内障超声乳化吸除术不影响角膜透明度，在玻璃体切除术中可实现水密性伤口闭合，并保留晶状体囊袋，从而允许后房型人工晶状体囊袋内固定。联合白内障超声乳化吸除术、后房型人工晶状体植入术和平坦部玻璃体切除术可使这些患者迅速恢复视力并获得功能性裸眼视力。
