后巩膜加固术联合超声乳化人工晶状体植入术治疗视网膜色素变性合并白内障

Posterior scleral reinforcement combined with phacoemulsification and IOL implantation for retinitis pigmentosa and cataract

目的探讨后巩膜加固术联合超声乳化人工晶状体植入术治疗视网膜色素变性(retinitispigmentosa,RP)合并白内障的临床疗效。方法 对RP合并白内障患者16例(30眼)进行回顾性分析,所有患者先行后巩膜加固术,再行白内障超声乳化人工晶状体植入术,术后1周、1个月、3个月、6个月分别复查视力,定期复查视野、视网膜电图。结果 患者术后视力提高≥2行者24眼,<2行者4眼,无提高者2眼;术前、术后1周、1个月、3个月、6个月视力差异有统计学意义(P<0.05或0.01)。术后第1天角膜内皮轻微水肿3眼,前房Tyndall征阳性5眼,经皮质类固醇类激素滴眼液局部滴眼后,均于2～7d内消退。术前、术后眼压均正常,无一过性高眼压,未发生人工晶状体移位、角膜内皮失代偿、视网膜脱离等严重并发症。与术前比较,所有患眼术后视野范围扩大或光敏感度提高。视网膜电图与术前无明显差异。结论 后巩膜加固术联合超声乳化人工晶状体植入术是治疗RP合并白内障的一种安全、有效的方法。

Objective To investigate the clinical efficacy of posterior scleral reinforcement combined with phacoemulsification and IOL implantation for retiuitis pigmentosa （RP） and cataract. Methods About 16 patients （30 eyes） with RP and cataract were retrospectively analyzed. The posterior scleral reinforcement combined with phacoemulsification and IOL implantation were performed in all patients, the visual acuity at postoperative 1 week, 1 month, 3 months and 6 months were recorded, the visual field and ERG were observed. Results There were 24 eyes with visual acuity improved be and more than 2 lines,4 eyes less than 2 lines,2 eyes without improvement, and statistical differences were found between visual acuity before and after operation （P 〈0.05 or 0. 01 ）. At postoperative 1st day,slight corneal edema appeared in 3 eyes, oositive Tyndall symotom in 5 eyes, all disappeared in 2 to 7 days after local dropping with corticosteroid hormone. The intraocular pressure before and after operation were all normal and without transient ocular hypertension, IOL deviation, corneal endothelial decompensation and retinal detachment. Compared with pre-operation, visual field enlarged,light sensitivity improved at post-operation. Conclusion Posterior scleral reinforcement combined with phacoemulsification and IOL implantation is a safe and effective method for patients with RP and cataract.