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玻璃体切割、超声乳化及人工晶状体植入联合手术的结果

Surgical results of combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation.

作者信息

Mochizuki Y, Kubota T, Hata Y, Miyazaki M, Suyama Y, Enaida H, Ueno A, Ishibashi T

机构信息

Department of Ophthalmology, National Nagasaki Medical Center, Nagasaki, Japan.

出版信息

Eur J Ophthalmol. 2006 Mar-Apr;16(2):279-86. doi: 10.1177/112067210601600214.

Abstract

PURPOSE

To evaluate the results and complications of combined pars plana vitrectomy (PPV), phacoemulsification and aspiration (PEA), and intraocular lens (IOL) implantation.

METHODS

A total of 117 eyes from 114 patients who had undergone PPV combined with PEA and IOL implantation were retrospectively analyzed. Combined surgery was performed for a wide variety of vitreoretinal diseases. Intraoperative and postoperative complications were also reviewed.

RESULTS

The postoperative BCVA improved by 2 lines or more in 85 eyes (72.6%). Intraoperative complications consisted of retinal tears in 14 eyes (12.0%) and posterior capsular rupture in 2 eyes (1.7%). Iatrogenic retinal tears occurred more frequently in eyes with a macular hole than in eyes with any other disease (p=0.005, chi-square test). Postoperative complications consisted of posterior capsule opacification (PCO) (21 eyes), transient IOP elevation (29 eyes), vitreous hemorrhage (6 eyes), anterior chamber fibrin exudation (11 eyes), posterior iris synechia (8 eyes), neovascular glaucoma (1 eye), and recurrent retinal detachment (RD) (2 eyes). Fibrin exudation occurred more frequently in eyes with proliferative diabetic retinopathy (PDR) and RD than in eyes with any other disease (p=0.03, chi-square test). PCO occurred more frequently in eyes with PDR than in eyes with any other disease (p=0.03, chi-square test).

CONCLUSIONS

The present study suggests that a high success rate can be achieved when recently improved PPV techniques are combined wi th PEA and IOL implantation. The complications that were observed following this combined treatment varied with respect to the vitreoretinal disease present prior to surgery.

摘要

目的

评估玻璃体切割联合白内障超声乳化吸除及人工晶状体植入术的效果及并发症。

方法

回顾性分析114例患者的117只眼,这些患者均接受了玻璃体切割联合白内障超声乳化吸除及人工晶状体植入术。联合手术用于多种玻璃体视网膜疾病。同时对术中及术后并发症进行了回顾。

结果

术后85只眼(72.6%)的最佳矫正视力提高了2行或更多。术中并发症包括14只眼(12.0%)出现视网膜裂孔和2只眼(1.7%)出现后囊膜破裂。黄斑裂孔眼发生医源性视网膜裂孔的频率高于其他任何疾病的眼(p=0.005,卡方检验)。术后并发症包括后囊膜混浊(21只眼)、短暂性眼压升高(29只眼)、玻璃体积血(6只眼)、前房纤维蛋白渗出(11只眼)、虹膜后粘连(8只眼)、新生血管性青光眼(1只眼)和复发性视网膜脱离(2只眼)。纤维蛋白渗出在增殖性糖尿病视网膜病变和视网膜脱离的眼中比在其他任何疾病的眼中更常见(p=0.03,卡方检验)。后囊膜混浊在增殖性糖尿病视网膜病变的眼中比在其他任何疾病的眼中更常见(p=0.03,卡方检验)。

结论

本研究表明,当将最近改进的玻璃体切割技术与白内障超声乳化吸除及人工晶状体植入术联合应用时,可以获得较高的成功率。联合治疗后观察到的并发症因手术前存在的玻璃体视网膜疾病而异。

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