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目的探讨联合或分次手术治疗并发白内障的视网膜脱离的疗效。设计回顾性病例系列研究。研究对象并发白内障的视网膜脱离患者70例(70眼)。方法根据手术方式分为A组50例(50眼),行白内障摘除+玻璃体切除联合手术。 B组20例(20眼),白内障摘除与玻璃体切除术分两次完成,两次手术间隔时间6-11(平均8±1．9)天。39眼(56％)植入IOL, 31眼(44％)未植入IOL。术后随访6-40(平均14．5±10_2)个月。主要指标术前与术后视力以及术后并发症。结果两组术后视力与术前相近或提高(P<0．05)。术后最佳矫正视力(BCVA):A组视力≥0．05者22眼(44％),≥0．1者19眼(38％),≥0．3 者4眼(8％)。Snellen视力提高范围1-7行。B组BCVA≥0．05者9眼(45％),≥0．1者6眼(30％),≥0.3者1眼(5％)。两组之间没有显著性差异。随访3年内,植入或不植入IOL对术后最佳矫正视力无明显影响(P>0．05)。后发障发生率:未植入组较植入组高;发生时间:未植入组平均6个月,植入组平均14个月。联合或分次的手术后并发症没有显著性差异。结论联合手术对于治疗并发白内障的视网膜脱离患者安全有效,适应证选择是手术成功的关键。
Objective To investigate the curative effect of combined or subtotal surgery on retinal detachment with cataract. Design retrospective case series. The study included 70 patients (70 eyes) with retinal detachment who had cataract. Methods According to the operation method, 50 cases (50 eyes) were divided into group A, cataract extraction and vitrectomy combined operation. Group B, 20 cases (20 eyes), cataract extraction and vitrectomy in two completed, two operation interval 6-11 (average 8 ± 1.9) days. Thirty-nine eyes (56%) were implanted with IOL and 31 eyes (44%) were not implanted with IOL. The patients were followed up for 6-40 months (average 14.5 ± 10_2) months. The main indicators of preoperative and postoperative visual acuity and postoperative complications. Results The postoperative visual acuity of the two groups was similar to that before operation (P <0.05). Postoperative best corrected visual acuity (BCVA): A group of visual acuity ≥ 0.05 in 22 eyes (44%), ≥ 0.1 in 19 eyes (38%), ≥ 0.3 in 4 eyes (8%). Snellen eyesight range 1-7 lines. There were 9 eyes (45%) with BCVA≥0.05 in group B, 6 eyes (≥30%) with ≥0.1 eyes and 5 eyes (≥0.3 eyes). There was no significant difference between the two groups. Within 3 years of follow-up, IOL with or without implanted had no significant effect on the best corrected visual acuity (P> 0.05). Incidence of post-traumatic disorders: no implantation group than the implantation group; Occurrence time: not implanted group an average of 6 months, the implantation group an average of 14 months. There was no significant difference in postoperative complications between combined or sub-groups. Conclusions Combined surgery is safe and effective for the treatment of retinal detachment complicated with cataract. The choice of indications is the key to successful operation.