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[已愈合或存在视网膜脱离或易发生视网膜脱离的患眼白内障手术的适应证、技术及结果]

[Indications, technics and results of cataract surgery on an eye effected with healed or present retinal detachment or predisposed to detachment].

作者信息

Guillaumat L, Massin M, Marsault M, Theron M P, Fleury P, Montagnon E

出版信息

Mod Probl Ophthalmol. 1977;18:480-4.

PMID:876096
Abstract

This communication is a survey of 53 cataract operations followed up during a period of 1-6 years, with an average of 4 years, and performed on patients who had a high risk of subsequent retinal detachment because of a preceding detachment on the fellow eye or on the cataractous eye, because of peripheral retinal degenerations, or a history of hereditary retinal detachment. Most of the operations were performed under general anesthesia and ocular hypotony. In all the cases, a limbal-based conjonctival flap with a double line of sutures (scleral and conjonctival), an iridectomy in segment, a zonulolysis and a cryoextraction, were done. As for the retina, 18 eyes received a coagulation before the cataract extraction by galvano- or cryocoagulation or even by xenon photocoagulation. Among them 3 had a detachment after the cataract extraction, but 2 of them were cured by a new operation. 15 eyes had peripheral retinal lesions which were coagulated after the cataract extraction by cryo-, laser or xenon coagulation. Nevertheless 2 had a detachment. 13 patients with a detachment on the fellow eye or in the family, had no peripheral lesion and were not coagulated. None of them had a retinal detachment after the cataract extraction. Finally the eyes operated upon a short time after the cataract extraction suffered severe complications: reopening of the cataract incision, loss of vitreous and finally loss of 2 eyes out of 3.

摘要

本文是一项对53例白内障手术的调查,随访时间为1至6年,平均4年。这些手术的患者因对侧眼或白内障眼先前有视网膜脱离、周边视网膜变性或有遗传性视网膜脱离病史,而有较高的后续视网膜脱离风险。大多数手术在全身麻醉和眼压降低的情况下进行。所有病例均采用基于角膜缘的结膜瓣双行缝合(巩膜和结膜)、扇形虹膜切除术、晶状体悬韧带松解术和冷冻摘除术。至于视网膜,18只眼在白内障摘除术前通过电凝、冷冻或甚至氙光凝进行了凝固。其中3只眼在白内障摘除术后发生了视网膜脱离,但其中2只通过再次手术治愈。15只眼有周边视网膜病变,在白内障摘除术后通过冷冻、激光或氙光凝进行了凝固。然而,仍有2只眼发生了视网膜脱离。13例对侧眼或家族中有视网膜脱离的患者,没有周边病变且未进行凝固。他们中没有一只眼在白内障摘除术后发生视网膜脱离。最后,在白内障摘除术后短时间内进行手术的眼睛出现了严重并发症:白内障切口重新裂开、玻璃体丢失,最终3只眼中有2只眼失明。

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