Boiko Ernest V, Churashov Sergey V, Kulikov Alexei N, Maltsev Dmitrii S
St. Petersburg Branch of the Academician S. Fyodorov IRTC "Eye Microsurgery", 21 Yaroslav Gashek Street, St. Petersburg 192283, Russia ; Department of Ophthalmology, Military Medical Academy, 5 Klinicheskaya Street, St. Petersburg 194044, Russia.
Department of Ophthalmology, Military Medical Academy, 5 Klinicheskaya Street, St. Petersburg 194044, Russia.
J Ophthalmol. 2015;2015:474072. doi: 10.1155/2015/474072. Epub 2015 Oct 26.
Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV), for the management of selected posterior segment intraocular foreign body (IOFB), posteriorly dislocated lens fragments (PDLF), and proliferative diabetic retinopathy (PDR) cases. Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes) we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI) and posterior capsulorhexis to remove IOFB (n = 8), PDLF from the vitreous cavity after complicated phacoemulsification (n = 6), and vitreous hemorrhage and epiretinal membranes in PDR (n = 7). The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI. Results. The mean visual acuity (logMAR) was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6-12 months). The intraocular lens was implanted into the capsular bag (n = 12) or onto the anterior capsule (n = 9). One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention. Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate.
目的。描述我们的技术，即带后囊连续环形撕囊的透明角膜晶状体玻璃体切除术（CCPV），用于治疗特定的眼后段眼内异物（IOFB）、晶状体后脱位碎片（PDLF）和增殖性糖尿病视网膜病变（PDR）病例。方法。这是一项单中心回顾性介入病例系列研究。我们对21例患者（21只眼）通过三个透明角膜隧道切口（CCTI）进行晶状体玻璃体切除术并进行后囊连续环形撕囊，以取出IOFB（8例）、复杂白内障超声乳化术后玻璃体腔中的PDLF（6例）以及PDR中的玻璃体出血和视网膜前膜（7例）。手术最后通过CCTI植入一枚疏水性丙烯酸人工晶状体。结果。术前平均视力（logMAR）为0.90，平均随访8.7个月（范围6 - 12个月）后提高至0.26。人工晶状体植入囊袋内（12例）或前囊膜上（9例）。1例PDR患者术中出现并发症，孤立的纤维血管粘连出血。1例IOFB患者发生明显的前部增殖性玻璃体视网膜病变，需要再次干预。结论。选定的玻璃体视网膜IOFB、PDLF和PDR病例可通过包括带后囊连续环形撕囊的透明角膜晶状体玻璃体切除术及人工晶状体植入的联合手术方法成功治疗，视觉效果良好且并发症发生率低。
