后房型人工晶体缝线固定术后视网膜脱离原因分析

Caue analysis of detachment following suture fixation of posterior chamber intraocular lens implantation

目的报告后房型人工晶体缝线固定术后视网膜脱离的临床特征。方法观察后房型人工晶体缝线固定术后视网膜脱离14例14[的患者背景、术中所见及术后观察。结果患者术后视网膜脱离发生在20～204日(平均96.5日),初次手术6[施行了巩膜环扎术,8[玻璃体手术。经玻璃体手术者视网膜全部解剖复位,3[巩膜外手术复位失败,后经玻璃体手术视网膜复位。视网膜脱离发生的原因是睫状沟缝合时医源性裂孔3[,前部玻璃体牵拉性网膜裂孔11[。术后视力提高的5[,不变者6[,3[视力下降。结论后房型人工晶体缝线固定术后前部玻璃体的牵拉是视网膜脱离的主要原因,玻璃体手术是有效的。另外,由于血—[屏障的破坏易发生前部增生性玻璃体病变,早期的玻璃体手术是重要的。

Objective To report clinical characteristic on fixation of posterior chamber intraocular lens implantation. Methods the retinal detachment following suture We retrospectively reviewed the records of 14 patients （14 eyes）, and analyzed background factors, intraoperative findings and surgical outcomes. Resuits Retinal detachment occurred from 20 to 204 days （mean 96.5 days） after suture fixation of posterior chamber intraocular lens implantation. Retinal detachment developed due to perforation of the retina by the fixation needle in 3 eyes, and due to formation of retinal tears with vitreous traction in 11 eyes. Primary vitrectomy was performed in 8 eyes and scleral buckling in 6 eyes. Retinal reattachment was achieved in all eyes that underwent vitrectomy, however both eyes that underwent scleral buckling developed proliferative vitrectomy postoperatively necessitationg subsequent vitreous surgery. Postoperative visual acuities improver more than 5 eyes, remained unchanged in 6 eyes, and worsened more than 3 eyes. Conclusion Primary vitrectomy appeared to be effective in treating retinal detachment following suture fixation of posterior chamber intraocular lens implantation, because most of our cases were associated with strong vitreous traction. Such retinal detachments should be immediately treated due to the higher risk of developing proliferative vireoretinopathy with breakdown of the blood-retinal barrier.