Sizmaz Selcuk, Esen Ebru, Isik Puren, Cam Burcu, Demircan Nihal
Cukurova University, School of Medicine, Department of Ophthalmology, Adana, Turkey.
J Ophthalmol. 2019 Mar 17;2019:7918237. doi: 10.1155/2019/7918237. eCollection 2019.
With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This combined surgery offers several advantages besides limitations. The aim of this study is to assess the outcome and complications of phacoemulsification combined with pars plana vitrectomy (PPV).
In this retrospective review, medical charts of patients undergoing phacovitrectomy for coexisting cataract and various vitreoretinal disorders were analyzed. Patient demographics, retinal diagnosis, visual acuities (VA) in logMAR, intraocular pressure (IOP), intraoperative and postoperative complications were assessed. Clear corneal phacoemulsification and 23-gauge transconjunctival PPV were administered in all cases.
Eighty-four eyes of 64 (76.2%) males and 20 (23.8%) females were enrolled. The average age of patients was 59.5 ± 13.8 (18-81). The average period of follow-up was 7.2 ± 7.5 months (1-36). The vitreoretinal diagnoses were as follows: 28 (33.3%) rhegmatogenous retinal detachment, 23 (27.4%) vitreous hemorrhage, 12 (14.3%) intraocular foreign body, 12 (14.3%) epiretinal membrane, 4 (4.8%) macular hole, 4 (4.8%) tractional retinal detachment, and 1 (1.2%) vitreomacular traction. The most common intraoperative complications were miosis and rupture of the posterior capsule (92.9% and 8.3%, respectively). In 8 (9.5%) cases, there was fibrin in the anterior chamber. Posterior synechia developed in 7 (8.3%) of cases. No severe increase in intraocular pressure was evident.
Phacoemulsification combined with PPV is a safe and efficient way of management in cases where cataract coexists with vitreoretinal pathologies.
随着手术工具的进步，同时摘除与玻璃体视网膜疾病相关的白内障越来越普遍。这种联合手术除了有局限性外，还具有多种优势。本研究的目的是评估超声乳化联合玻璃体切割术（PPV）的疗效和并发症。
在这项回顾性研究中，分析了因白内障合并各种玻璃体视网膜疾病而接受晶状体玻璃体切除术患者的病历。评估了患者的人口统计学特征、视网膜诊断、以最小分辨角对数（logMAR）表示的视力（VA）、眼压（IOP）、术中及术后并发症。所有病例均采用透明角膜超声乳化术和23G经结膜玻璃体切割术。
纳入了64例男性（76.2%）和20例女性（23.8%）的84只眼。患者的平均年龄为59.5±13.8岁（18 - 81岁）。平均随访时间为7.2±7.5个月（1 - 36个月）。玻璃体视网膜诊断结果如下：孔源性视网膜脱离28例（33.3%），玻璃体出血23例（27.4%），眼内异物12例（14.3%），视网膜前膜12例（14.3%），黄斑裂孔4例（4.8%），牵拉性视网膜脱离4例（4.8%），玻璃体黄斑牵拉1例（1.2%）。最常见的术中并发症是瞳孔缩小和后囊破裂（分别为92.9%和8.3%）。8例（9.5%）病例前房有纤维蛋白。7例（8.3%）病例发生了虹膜后粘连。未发现眼压明显大幅升高。
在白内障与玻璃体视网膜病变并存的情况下，超声乳化联合PPV是一种安全有效的治疗方法。
