一期单纯玻璃体切除术治疗人工晶状体眼孔源性视网膜脱离

Primary vitrectomy for pseudophakic rhegmatogenous retinal detachment

目的通过对人工晶状体眼孔源性视网膜脱离（PsRD）患者实施一期单纯玻璃体切除手术的观察，探讨治疗PsRD的安全有效地手术方法。方法回顾性选择PsRD患者38例38只眼，全部采用一期单纯睫状体平坦部标准三通道玻璃体手术治疗，术中行眼内激光光凝裂孔和变性区，或实施经巩膜冷凝术。术后观察疗效。结果术中裂孔检出率为100％，最终手术解剖复位率为100％，术后6个月视力提高者29只眼，不变者9只眼，无下降者。结论一期玻璃体切割术治疗人工晶状体眼视网膜脱离，具有手术成功率高，术中视野好，可解除所有视网膜的增殖和牵拉，不遗漏裂孔的特点，值得临床推广应用。

Objective To discuss the most effective and safe surgery to cure the pseudophakic rhegmatogenous （PsRD） by performing the phase one operation of simple vitrectomy and the succeed-ing observation. Methods Selected 38 PsRD cases with 38 eyes, cured them all with the phase one vitrectomy of the orbiculus ciliaris standard 3 channels. At the same time, used laser photocoagu- lation on the hiatus and the degenerated area, or implement the cryocoagulation through sclera. Effi- cacy after the operation was observed. Results The operation achieved 100% detectable rate on the hiatus and the final restoration after operation had been 100%, 29 out of 38 improved the vision, 9 out of 38 stay unchanged and no worse case, Conclusions The Phase one vitrectomy is used for the treatment of retina detachment with artificial lens. It is effective with a good vision during the operation and can remove all the multiplication and tractive of the retina without missing any hiatus.