超声乳化人工晶状体植入联合巩膜扣带术治疗白内障合并视网膜脱离

Combined phacoemulsitlcation, intraocular lens implantation and scleral buckling for eyes with coexisting cataract and retinal detachment

目的探讨超声乳化、人工晶状体植入联合巩膜扣带术治疗白内障合并视网膜脱离效果。方法对上海交通大学附属第一人民医院眼科就诊的12例（12只眼）白内障合并视网膜脱离患者实施晶状体超声乳化吸除、人T晶状体植人及巩膜扣带手术，观察术后视网膜复位、最佳矫正视力（BCVA）和并发症情况。结果视网膜复位11只眼（11／12，即91．7％），术后最佳矫正视力提高10只眼（10／12，即83．3％），最佳矫正视力不变1只眼（1／12，即8．3％），最佳矫正视力下降1只眼（1，12，即8．3％）。主要的术后并发症角膜水肿3只眼（3／12，即25．0％），中度的纤维蛋白渗出3只眼（3／12，即25．0％），一过性眼内压力升高2只眼（2／12，即16．6％），后囊膜混浊2只眼（2／12，即16．6％），复发性视网膜脱离1只眼（1／12，即8．3％）。结论超声乳化、人工晶状体植入联合巩膜扣带术治疗白内障合并视网膜脱离是安全有效的。

Objective To investigate the effect of combined phacoemulsification, intraocular lens implantation and scleral buckling surgery for eyes with coexisting cataract and retinal detachment. Methods A case series of 12 consecutive patients （12 eyes） underwent combined phacoemulsification, intraocular lens implantation and scleral buckling surgery. The main outcome measures were postopera- tive retinal reattachment, best corrected visual acuity （BCVA）, and complications. Results Overall reti- nal reattachment occurred in 11 eyes （11/12, as 91.7%）. Postoperative BCVA improved in 10 eyes （10/ 12, as 83.3%）, unchanged in 1 eye （1/12, as 8.3%）, and worsened in 1 eye （1/12, as 8.3%）. The ma- jor postoperative complications were corneal edema in 3 eyes （3/12, as 25%）, moderate fibrin exuda- tion 3 eyes （3/12, as 25%）, transient increased intraocular pressure in 2 eyes （2/12, as 16.6%）, posteri- or capsule opacification in 2 eyes （2/12, as 16.6%）, and recurrent retinal detachment in 1 eye （1/12, as 8.3%）. Conclusions Combined phacoemulsification, intraocular lens implantation and scleral buck- ling surgery for eyes with coexisting cataract and retinal detachment are safe and effective.