高度近视白内障囊外摘除术后视网膜脱离及其危险因素的研究

The incidence of retinal detachment after extracapsular cataract extraction in high myopia

为探讨在现代白内障囊外摘除的条件下，高度近视白内障囊外摘除术后视网膜脱离的发生率及其危险因素，对１９９３年７月至１９９４年１月在我院施行白内障囊外摘除术及白内障囊外摘除并后房型人工晶体植入的高度近视及老年性白内障的病人按病历序号进行登记随访，排除随访条件不良的病例，随访时间为２７～３３个月，观察术后视网膜脱离的发生率。结果：高度近视组视网膜脱离的发生率为１１１％（１／９０），老年性白内障组无视网膜脱离发生（０／３７３），差别无统计学意义（Ｐ＞００５）。高度近视组中Ｎｄ：ＹＡＧ激光后囊膜切开术的使用率高于老年性白内障组（Ｐ＜００５）。结论：保留完整后囊膜的白内障囊外摘除术使高度近视白内障术后视网膜脱离的发生率下降，术后发生视网膜脱离的危险因素是：年龄较轻、眼轴长及继之而施行的后囊膜切开术。避免与减少后发性白内障的形成以及术前、术后的眼底检查与治疗是预防术后视网膜脱离的有效措施。

A retrospective study was performed to determine the incidence of retinal detachment after extracapsular cataract extraction in high myopia and the risk factors associated with the occurence of retinal detachment.Methods:Of the 463 patients(463 eyes) who had undergone extracapsular cataract extraction with or without intraocular lenses implant between July 1993 and January 1994,90 patients companied with high myopia and the others were senior cataract.All patients had been followed up for 27 to 33 months.Results:One(1 11%)developed retinal detachment in the patients with high myopia,and no retinal detachment ocurred in the patients with senior cataract.The difference of the incidence of retinal detachment between two grops were no significant(P>0 05).More myopic patients underwent Nd:YAG laser capsulotomy(P<0 05).Conclution:Comparing with intracasular method,extracapsular cataract extraction decreased the risk of retinal detachment even in the high myopic patients.The risk factors for retinal detachment were young patients,long eye axis and posterior capsulotomy.