高度近视眼黄斑裂孔性视网膜脱离伴晶状体混浊治疗术式的选择

TREATMENT METHOD OF RETINAL DETACHMENT DUE TO MACULAR HOLE ACCOMPANIED WITH CATARACT IN HIGH MYOPIC EYES

目的评价玻璃体切割术联合超声乳化一期不植入人工晶状体治疗高度近视眼黄斑裂孔性视网膜脱离伴随晶状体混浊的效果。方法回顾分析伴随晶状体混浊的高度近视黄斑裂孔性视网膜脱离9眼,行玻璃体切割术联合超声乳化一期不植入人工晶状体,术后玻璃体腔填充C_3F_8气体,术后观察黄斑裂孔封闭、视网膜解剖复位、视力变化和并发症情况。随访4～12个月,平均5.3个月。结果 9眼中最终视网膜复位8眼,其中1次手术后视网膜复位7眼;二期植入人工晶状体2眼。视网膜复位的患者均获得视力提高及主观感觉的显著改善。结论玻璃体切割术联合超声乳化一期不植入人工晶状体是治疗高度近视黄斑裂孔性视网膜脱离伴随晶状体混浊的安全有效的手术方法,可作为治疗高度近视黄斑裂孔性视网膜脱离伴随晶状体混浊的一种选择。

Objective To evaluate the clinical effects of vitrectomy combined with phacoemulsification without intraocular lens implantation at the same time in the treatment of retinal detachment due to macular hole accompanied with cataract in high myopic eyes. Methods Nine high myopic eyes of retinal detachment due to macular hole accompanied with cataract were undergone vitrectomy combined with phacoemulsification without intraocular lens implantation at the same time. Gas C3Fs was tamponaded in the vitreous bodies after the surgery. The closure of macular hole, retinal reattachment, postoperative visual acuity, and complications were observed. The time of follow up was 4 to 12 months with an average of 5.3 months. Results Retina was reattached in 8 of 9 eyes. Among 8 eyes, retina was reattacbed in 7 eyes after the first operation and intraocular lens implantation at the second time was undergone in 2 eyes. Patients with retinal reattachment had significant improvement of vision. Conclusion It is a safe and effective method to treat retinal detachment due to macular hole accompanied with cataract in high myopic eyes with vitrectomy combined with phacoemulsification without intraocular lens implantation at the same time. Due to the amelioration of refracting media after operation, the subjective visual feelings of the patients were improved significantly. The combined surgery without intraocular lens implantation at the same time may ：be regarded as a better choice for treatment of retinal detachment due to macular hole accompanied with cataract in high myopic eyes.