玻璃体切除联合白内障超声乳化吸除人工晶状体植入术后并发症分析

The clinical analysis of postoperative complications with vitrectomy combined phacoemulsification and intraocular lens implantation for vitreoretinopathy

目的探讨玻璃体切除术联合白内障超声乳化吸除和人工晶状体植入术的有效性和安全性。方法回顾性分析2000年1月至2007年12月施行联合手术的玻璃体视网膜病变患者81例（82只眼）。其中男33例（33只眼），女48例（49只眼），年龄26—78岁，平均57岁；术后随访8～58个月，平均26个月。对术后并发症进行了分析。结果术后视力提高有55只眼（67．07％）；视力不变25只眼（30．49％），视力下降2只眼（2．44％）。术后主要并发症包括角膜轻度水肿10只眼（12．20％）；暂时性眼压升高26只眼（31．70％）；前房渗出12只眼（14．63％）；虹膜后粘连6只眼（7．32％）；玻璃体再出血5只眼（6．10％）；视网膜脱离3只眼（3．66％）；新生血管性青光眼6只眼（7．32％）；术后6个月至2年后囊膜混浊12只眼（14．63％）。结论联合手术及折叠式人工晶体植入治疗伴有白内障的玻璃体视网膜病变是安全有效的方法，术后较快地恢复视力，术后并发症大多数轻微，但糖尿病玻璃体视网膜病变术后并发症相对较多。

Objective To observe the safety and efficacy ofvitrectomy combined phacoemulsification and intraocular lens implantation to treat vitrereotinopathy.Method Retrospectively analyzed the clinical data of 81 cases （82 eyes）with vitrereotinopathy who underwent combined surgery from January 2000 to December 2007.The follow-up period was 8 to 58 months with the average of 26 months.The postoperation complications were analyzed.Results Postoperative visual improvement was achieved in 55 eyes（67.07%）, visual acuity remained unchanged in 25 eyes（30.49%）and decreased in 2 eyes （2.44%）.Postoperatiye complications consisted of a mild corneal edema in 10 eyes （ 12.20% ）, transient intraocular pressure increase in 26 eyes （ 31.70% ） ; anterior chamber fibrin exudation in 12 eyes （ 14.63 % ）, vitreous hemarrhage in 5 eyes （ 6.10% ）, retinal detachment in 3 eyes（3.66% ）,neovaseular glaucoma in 6 eyes（7.32% ）;posterior capsule opacification（PCO）in 12 eyes （14.63%）.Conclusion Vitrectomy combined with phacoemulsification and IOL implantation in vitreoretinopathy patients is a safe and effective approach, and provide rapid visual rehabilitation without significant complications in the majority of selected eyes after surgery,but more frequently in proliferative diabetic retinopathy（PDR）.