Igarashi Chizuka, Hayashi Hideyuki, Hayashi Ken
Hayashi Eye Hospital, 4-7-13 Hakataekimae, Hakata-ku, Fukuoka 812-0011, Japan.
J Cataract Refract Surg. 2004 Jul;30(7):1412-7. doi: 10.1016/j.jcrs.2003.12.024.
To evaluate the outcomes of phacoemulsification in eyes that had previous retinal detachment (RD) surgery.
Hayashi Eye Hospital, Fukuoka, Japan.
Ninety-six eyes of 90 consecutive patients who had phacoemulsification after previous RD surgery (RD group) were included. Fifty-one fellow eyes that had not had RD surgery but did have phacoemulsification served as controls (control group). Recurrence of RD, visual acuity, complications, and the neodymium:YAG (Nd:YAG) laser capsulotomy rate were examined.
Recurrent RD after phacoemulsification occurred in 2 eyes (2.1%) in the RD group. Three eyes (5.9%) in the control group developed RD postoperatively. The incidence of RD was not significantly different between the 2 groups (P =.3416). The mean final visual acuity in the RD group was 20/30, significantly worse than in the control group (P =.0099). Posterior capsule opacification developed in 29 eyes (30.2%) in the RD group and 11 eyes (21.6%) in the control group; the difference between the groups was not significant. Eighteen eyes (43.9%) that had implantation of a poly(methyl methacrylate) (PMMA) intraocular lens (IOL) and 7 eyes (6.6%) that received an acrylic IOL had an Nd:YAG capsulotomy; the capsulotomy rate was significantly higher in eyes with a PMMA IOL than in eyes with an acrylic IOL (P<.0001).
The rate of recurrent RD after phacoemulsification in eyes that had previous RD surgery was similar to that of new occurrence of RD in fellow eyes without RD before phacoemulsification. Because the Nd:YAG capsulotomy rate was lower in eyes with acrylic IOLs than in eyes with PMMA IOLs, acrylic IOLs are recommended for eyes at high risk for RD.
评估曾接受视网膜脱离(RD)手术的眼睛行超声乳化白内障吸除术的效果。
日本福冈市林眼科医院。
纳入90例连续患者的96只曾接受RD手术后行超声乳化白内障吸除术的眼睛(RD组)。51只未接受RD手术但接受了超声乳化白内障吸除术的对侧眼作为对照(对照组)。检查RD复发情况、视力、并发症以及钕:钇铝石榴石(Nd:YAG)激光晶状体后囊切开术发生率。
RD组中2只眼(2.1%)在超声乳化白内障吸除术后发生RD复发。对照组中有3只眼(5.9%)术后发生RD。两组间RD发生率无显著差异(P = 0.3416)。RD组的平均最终视力为20/30,显著低于对照组(P = 0.0099)。RD组29只眼(30.2%)发生后囊膜混浊,对照组11只眼(21.6%)发生后囊膜混浊;两组间差异不显著。植入聚甲基丙烯酸甲酯(PMMA)人工晶状体(IOL)的18只眼(43.9%)和植入丙烯酸酯IOL的7只眼(6.6%)接受了Nd:YAG后囊切开术;植入PMMA IOL的眼睛的后囊切开术发生率显著高于植入丙烯酸酯IOL的眼睛(P<0.0001)。
曾接受RD手术的眼睛行超声乳化白内障吸除术后RD复发率与超声乳化白内障吸除术前未发生RD的对侧眼新发RD的发生率相似。由于植入丙烯酸酯IOL的眼睛的Nd:YAG后囊切开术发生率低于植入PMMA IOL的眼睛,因此对于RD高危眼推荐使用丙烯酸酯IOL。