前后段联合手术治疗玻璃体视网膜疾病合并白内障的临床研究

Clinical study on joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract

目的研究前后段联合手术治疗玻璃体视网膜疾病合并白内障的临床效果。方法选择伴有不同程度晶状体混浊的玻璃体视网膜疾病患者共78例，均一次性子玻璃体切割和白内障摘出前后段联合手术，观察其视力改善情况与并发症。结果该组78例患者86眼中，术后视力提高88．4％（76／86），视力不变7．0％（6／86），视力下降4．7％（4／86）。4眼视力下降患者中1眼为继发新生血管性青光眼，2眼为伴黄斑出血或裂孔，1眼为术后视网膜再脱离。Ⅰ期未植入人工晶状体的72眼，术后矫正视力提高63眼（87．5％），1期植入人工晶状体14眼，视力均改善（100％），两者差异无统计学意义（P〉0．05）。前后段联合手术治疗玻璃体视网膜疾病合并白内障总并发症发生率10．5％（9／86）。结论采用前后段联合手术治疗玻璃体视网膜疾病合并白内障疗效确切，并发症较少，值得临床进一步推广应用。

Objective To study on the effect of joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract. Methods 78 vitreoretinal diseases patients complicated with cataract （86 eyes） were recruited. All the cases accepted vitrectomy and cataract extraction at the same time. The vision improving situation and postoporative complications of the treatment were analyzed. Results After the joint surgery, of anteriorposterior, the visual improvement rate was 88.4% （76/86 eyes）, and with unchanged vision in 7.0%, and decreased vision in 4.7%. In 4 patients with decreased vision, 1 case was a secondary neovascular glaucoma ,aad 2 cases were macular hemorrhage or hiatus, 1 case was a retinal detachment. In phase 1,72 eyes did not implant artificial lens, 63 eyes （87.5 % ） got postoperatively improved vision, and 14 eyes implanted artificial lens, and all of them got improved vision （ 1 00.0% ）, and the difference was not statistically significant （ P 〉 0.05 ）. The total postoperative complication rate was 10. 5 % （9/86 eyes）. Conclusion Joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract had determined curative effect and lower complication rate ,which deserved further study and widely using.