无晶体眼和人工晶体眼视网膜脱离临床分析

Clinical analysis of aphakic and pseudophakic retinal detachment

本文回顾性分析了１１４例１２０眼无晶体眼视网膜脱离（ＡＲＤ）和人工晶体眼视网膜脱离（ＰＰＲＤ）。发现这两种视网膜脱离发病早，发展迅速，眼内病变复杂、严重，术前眼内检查困难，手术治疗效果不佳。严重的增殖性玻璃体视网膜病变（ＰＶＲ）和黄斑脱离被确认为独立影响其解剖和功能预后的最重要因素，而ＰＶＲ加重是手术失败的主要原因。成功地完成囊外摘除术或超声乳化术及囊袋内人工晶体植入术能减少ＡＲＤ和ＰＰＲＤ发生。在此基础上，对高危病人密切随访，在细致的术前检查后及早圆满地完成手术能改善预后。

eyes in 114 inpatients with Aphakic retinal detachment(ARD)or Pseudophakic retinal detachment(PPRD)were studied retrospectively.ARD and PPRD happen and spread promptly,often present complicated and severe changes in the eyes,difficulties in examination and poor results after routine treatments.Severe proliferative vitreoretinopathy(PVR)and macular detachment are identified as the two most significant risk factors independently affecting anatomic and functional prognoses,and aggravating PVR is the primary factor of final failures.Successfully proceeding extracapsular cataract extraction or phacoemulsification combined with posterior chamber intraocular lens implantation may reduce the high incidences of ARD and PPRD.Thereby follow those patients in high risks carefully ,perform perfect surgery as early as possible after careful examination may increase their reattachment rates and salvage some visual acuity.