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23G玻璃体切割联合超声乳化及撕囊术治疗伴有脉络膜脱离的孔源性视网膜脱离且未植入人工晶状体的疗效

Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment.

作者信息

Xu Huiyan, Lutrin David, Wu Zhifeng

机构信息

Department of Ophthalmology, Nanjing Medical University Affiliated Wuxi Second Hospital, Wuxi, Jiangsu Province, China University of California, San Francisco, CA.

出版信息

Medicine (Baltimore). 2017 Aug;96(34):e7869. doi: 10.1097/MD.0000000000007869.

Abstract

Rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) is a special type of complex retinal detachment, and usually has a poor prognosis. This study aimed to assess the anatomical outcomes of 23-gauge pars plana vitrectomy (23G PPV) combined with phacoemulsification (phaco) and capsulotomy without intraocular lens (IOL) implantation in patients with RRDCD.Seventy-six consecutive patients with RRDCD, who underwent retinal repair surgery from January 2010 to December 2014, were retrospectively analyzed. Forty patients underwent 23G PPV + phaco + IOL implantation, and 36 underwent 23G PPV + phaco + capsulotomy without IOL implantation (i.e., aphakia). All cases were filled with silicone oil. The follow-up time was 6 months after silicone oil was removed. Multivariate logistic regression analysis was the statistical method used.The overall retinal anatomical reattachment rate was 58% (44/76): 40% (16/40) of patients receiving 23G PPV + phaco + IOL implantation; and 78% (28/36) of patients receiving 23G PPV + phaco + capsulotomy + aphakia (P = .007).Surgical repair using 23G PPV + phaco + capsulotomy without IOL implantation can improve anatomical reattachment rates in patients with RRDCD.

摘要

孔源性视网膜脱离合并脉络膜脱离(RRDCD)是一种特殊类型的复杂性视网膜脱离,通常预后较差。本研究旨在评估23G经睫状体平坦部玻璃体切除术(23G PPV)联合超声乳化白内障吸除术(phaco)及晶状体囊切开术且未植入人工晶状体(IOL)治疗RRDCD患者的解剖学预后。对2010年1月至2014年12月期间连续76例行视网膜修复手术的RRDCD患者进行回顾性分析。40例患者接受了23G PPV + phaco + IOL植入术,36例接受了23G PPV + phaco +晶状体囊切开术且未植入IOL(即无晶状体眼)。所有病例均填充硅油。随访时间为硅油取出后6个月。采用多因素logistic回归分析作为统计方法。视网膜整体解剖复位率为58%(44/76):接受23G PPV + phaco + IOL植入术的患者为40%(16/40);接受23G PPV + phaco +晶状体囊切开术+无晶状体眼的患者为78%(28/36)(P = 0.007)。采用23G PPV + phaco +晶状体囊切开术且未植入IOL进行手术修复可提高RRDCD患者的解剖复位率。

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本文引用的文献

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Choroidal effusions and hypotony caused by severe anterior lens capsule contraction after cataract surgery.
Am J Ophthalmol. 2000 Feb;129(2):253-4. doi: 10.1016/s0002-9394(99)00319-0.

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