Regnault F, Bregeat P
Mod Probl Ophthalmol. 1977;18:538-40.
We have examined 243 cases with retinal detachment occurring within 6 months following cataract surgery. In 92 of them retinal tear was due to lattice degeneration, in 66 to snail track degeneration and in 17 to equatorial degeneration. 290 other patients had preventive treatments. In this group, there were only 10 cases of retinal detachment. 9 out of 22 patients who had no preventive treatment suffered retinal detachments. There are two reasons for the occurrence of this retinal detachment in the 6 months following cataract surgery in eyes where retinal degenerations are found: (1) surgical trauma even with cryoextraction is responsible for traction of the vitreous base, (2) rapid disappearance of the hyaluronic acid in the aphakic vitreous is responsible for the degradation of the vitreous with formation of large zones of liquid vitreous. When adhesion between the vitreous and the retinal degeneration area remains, the traction is responsible for retinal tear or retinal detachment. The importance of the preventive treatment of retinal lesions prior to cataract surgery should be stressed.
我们检查了243例白内障手术后6个月内发生视网膜脱离的病例。其中92例视网膜裂孔是由于格子样变性,66例是由于蜗牛迹样变性,17例是由于赤道部变性。另外290例患者接受了预防性治疗。在这组患者中,仅有10例发生视网膜脱离。22例未接受预防性治疗的患者中有9例发生了视网膜脱离。在发现有视网膜变性的眼中,白内障手术后6个月内发生这种视网膜脱离有两个原因:(1)即使是冷冻摘除术,手术创伤也会导致玻璃体基底部受到牵拉;(2)无晶状体眼玻璃体中透明质酸迅速消失,导致玻璃体退变并形成大片液化玻璃体区域。当玻璃体与视网膜变性区域之间存在粘连时,牵拉会导致视网膜裂孔或视网膜脱离。应强调在白内障手术前对视网膜病变进行预防性治疗的重要性。