合并白内障的黄斑裂孔视网膜脱离最小量手术治疗的临床观察

Clinical Observation on the Minimal Surgery for Macular Hole with Retinal Detachment and Cataract

目的:探讨对合并白内障的黄斑裂孔视网膜脱离病例行最小量手术治疗的临床疗效。方法:回顾性分析对合并白内障的黄斑裂孔性视网膜脱离患者32例32眼,行白内障超声乳化摘除术、人工晶体植入联合玻璃体腔注气术治疗,手术后随诊9～12个月,以视网膜复位情况、最佳矫正视力、多焦ERG、术后并发症作为临床疗效观察的指标。结果:黄斑裂孔闭合率96.8%;最佳矫正视力提高率为93.8%;多焦ERG显示术后9个月中央峰较术前明显恢复。结论:对于合并白内障,并且不存在玻璃体及增殖膜牵引的黄斑裂孔局限性视网膜脱离的患者,应用白内障超声乳化摘除、人工晶体植入联合玻璃体腔注气术治疗操作简捷、安全有效。

Objective：To evaluate the effect of the minimal surgery for macular hole（MH）with retinal detachment（RD） and cataract.Methods：A retrospective analysis was made for 32eyes with cataract and RD resulting from MH of 32 cases treated with minimal surgery（Phacoemulsification＋ IOL implantion ＋intravitreal gas injection）.The follow-up period was 9～12 months.The main distingaishable index measures included the anatomic reattachment rate,the change of the best corrected visual acuity（BCVA）,the result of multifocal ERG and the postoperative complication rate.Results：Anatomic reattachment rate was 96.8%,the BCVA improvement rate was 93.8%, the central peaks of mERG topographies reappeared little by little in 9 month after the surgery.Conclusion：Minimal surgery（Phacoemulsification ＋ IOL implantion ＋intravitreal gas injection） is safe and effective treatmemt for the patients of MH with RD and cataract,but without the traction of vitreous or proliferative membane.