视网膜脱离晶状体切除术中保留前囊膜的临床观察

Lensectomy preserving anterior lens capsule in retinal detachment surgery

目的观察视网膜脱离晶状体切除术中保留前囊膜的疗效。方法视网膜脱离34例(34眼)患者行视网膜脱离晶状体切除术,术中切除晶状体及玻璃体,保留前囊膜,同时行硅油填充。术后随访6～24个月,平均18.5个月,观察患者随访末期视网膜复位、视力及并发症情况。结果术后视网膜裂孔封闭、视网膜复位21例,复位率61.8%。术后视力高于术前,差异有统计学意义(P<0.05)。术后并发症有角膜水肿伴硅油继发性青光眼、前房纤维素性渗出、玻璃体再次积血、黄斑区及周围视网膜点状出血、渗出等。结论视网膜脱离晶状体切除术中保留前囊膜可减少并发症的发生,有利于视力提高。

Objective To observe the clinical effects of lensectomy preserving intact anterior lens capsule in retinal detachment surgery. Methods Thirty-four patients （34 eyes） with retinal detachment underwent lensectomy-vitrectomy.The anterior capsule remained and silicone oil was tamponade.The follow-up time was from 6 months to 24 months,averaged 18.5 months,the retinal reattachment,visual acuity and complications at the final follow-up were observed. Results The retinal broken holes were closed and the retinas were reattached in 21 cases,the reattached rate was 61.8%.The postoperative visual acuity was better than pre-operation,there was statistical difference（P〈0.05）.The postoperative complications included corneal edema with silicone secondary glaucoma,anterior chamber fibrin exudation,vitreous hemorrhage again,retinal point-like bleeding and exudation in macular area or around it. Conclusion Preserving anterior capsule in lensectomy can reduce the postoperative complications and improve the visual acuity.