Smiddy W E, Flynn H W, Kim J E
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, FL 33136, USA.
Ophthalmic Surg Lasers. 1996 Oct;27(10):856-61.
Retinal detachment is a complication of dislocated crystalline and intraocular lenses. The purpose of this study was to compare the frequency and management of coexisting or subsequent retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses (PC IOLs).
A retrospective, consecutive series of patients undergoing vitrectomy for dislocated PC IOLs (99 eyes) or removal of retained lens material (80 eyes) were studied.
Eyes with retinal detachment and retained lens fragments (2 cases) or dislocated PC IOLs (2 cases), or retinal detachment following vitrectomy for removal of retained lens fragments (2 cases) or repair of dislocated IOL (1 cases) were identified. The prevalence of coexisting or postoperative retinal detachment and retained lens fragments (5% total) was slightly higher than the prevalence of coexisting or postoperative retinal detachment and dislocated PC IOLs (3% total). The retina was reattached in all cases using the standard scleral buckling and vitrectomy techniques.
The rate of retinal detachment associated with retained lens material is decreased compared with previous reports. This may possibly be a results of increasing attention to minimizing surgical trauma by the cataract surgeon at the time of lens fragment loss and by the vitrectomy surgeon during primary repair.
视网膜脱离是晶状体脱位和人工晶状体脱位的一种并发症。本研究的目的是比较晶状体碎片残留或后房型人工晶状体(PC IOL)脱位患者中并存或后续发生视网膜脱离的频率及处理方法。
对因PC IOL脱位(99眼)或取出残留晶状体物质(80眼)而接受玻璃体切除术的患者进行了一项回顾性、连续性研究。
发现了伴有视网膜脱离及晶状体碎片残留(2例)或PC IOL脱位(2例)的眼,或在玻璃体切除术后因取出残留晶状体碎片(2例)或修复脱位人工晶状体(1例)而发生视网膜脱离的眼。并存或术后视网膜脱离与晶状体碎片残留的发生率(总计5%)略高于并存或术后视网膜脱离与PC IOL脱位的发生率(总计3%)。所有病例均采用标准巩膜扣带术和玻璃体切除术使视网膜复位。
与既往报道相比,与残留晶状体物质相关的视网膜脱离发生率有所降低。这可能是由于白内障手术医生在晶状体碎片丢失时以及玻璃体切除手术医生在初次修复时越来越重视尽量减少手术创伤的结果。