Schinz H, Schütte E
Abteilung Augenheikunde, Bundeswehrkrankenhaus, Ulm/Donau, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(2):142-7.
The incidence of retinal detachment following cataract extraction was studied in a myopic population of 803 eyes, which were selected by a measurement of the axial length out of 3,184 cases consecutively operated on. The incidence of retinal detachment following intracapsular cataract extraction was 1.5%, which was very similar to that after extracapsular cataract extraction: 1.8%, in the lowest range of date published in the literature. The incidence of retinal detachment of the pseudophakic myopic eye (operated on with the extracapsular technique, combined with implantation of a posterior chamber lens, the PMMA optic disc, diameter 5.8 mm with a 10 degrees angulated haptic and modified prolene-C loops) was 1.1%, in which the cases of intraoperative posterior capsule rupture with vitreous loss were included. There was no correlation between the incidence of retinal detachment and axial length. All cases of retinal detachment appeared in eyes with an axial length of 24.2 to 27.0 mm. In 9 of 11 (75%), retinal detachments occurred during the first 18 months after cataract extraction. In our opinion extracapsular cataract extraction with implantation of a posterior chamber lens is the best method of providing postoperative retinal detachment of the cataractous myopic eye. The question of the incidence of retinal detachment following cataract removal by the extracapsular technique and secondary capsulotomy by the Nd-YAG laser is still interesting.
在3184例连续接受白内障手术的病例中,通过测量眼轴长度,选取了803只近视眼睛,研究白内障摘除术后视网膜脱离的发生率。囊内白内障摘除术后视网膜脱离的发生率为1.5%,与囊外白内障摘除术后的发生率(1.8%)非常相似,处于文献报道的最低范围。人工晶状体近视眼中视网膜脱离的发生率(采用囊外技术手术,联合植入后房型人工晶状体,聚甲基丙烯酸甲酯光学部直径5.8mm,襻呈10度角,改良聚丙烯-C襻)为1.1%,其中包括术中后囊破裂伴玻璃体脱出的病例。视网膜脱离的发生率与眼轴长度之间无相关性。所有视网膜脱离病例均出现在眼轴长度为24.2至27.0mm的眼睛中。11例中有9例(75%)视网膜脱离发生在白内障摘除后的前18个月内。我们认为,囊外白内障摘除联合植入后房型人工晶状体是预防白内障性近视眼睛术后视网膜脱离的最佳方法。通过囊外技术摘除白内障后再行Nd-YAG激光后囊切开术后视网膜脱离的发生率问题仍然值得关注。