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目的 评估伴发白内障及人工晶状体的玻璃体视网膜手术的治疗效果及其影响因素。方法 玻璃体视网膜手术及硅油充填 92例 (94眼 )分为 3组 :保留晶状体前囊组 (第 1组 ) 2 9眼 ;未保留前囊组 (第 2组 ) 5 6眼 ;人工晶状体眼组 (第 3组 ) 9眼 ,术后随访 6月～ 1年 ,比较 3组的疗效及术后并发症。结果 3组视网膜完全复位率分别为 93 1% ,75 %及 88 9%。第 2组术后高眼压 ,硅油进入前房及角膜病变的并发症高于第 1组及第 3组 ,其中硅油进入前房的发生第 1组与第 2组相比差异有显著性 (χ2 =2 1.86 94,P <0 .0 1)。结论 保留晶状体前囊是治疗伴有白内障的复杂视网膜脱离的一种有效手段。伴有人工晶状体植入的玻璃体视网膜手术中可安全地应用硅油作为玻璃体腔的替代物。
Objective To evaluate the therapeutic effect and its influential factors of vitreoretinal surgery with cataract and intraocular lens. Methods Ninety-two eyes (94 eyes) with vitreoretinal surgery and silicone oil filling were divided into 3 groups: 29 eyes were preserved in the anterior lens group (group 1), 56 eyes were left in the anterior capsule group (group 2) (Group 3), 9 eyes were followed up for 6 months to 1 year. The curative effect and postoperative complication of the three groups were compared. Results The complete retinal reattachment rates of the three groups were 93 1%, 75% and 88 9% respectively. Group 2 postoperative intraocular hypertension, silicone oil into the anterior chamber and corneal complications than those in Group 1 and Group 3, including silicone oil into the anterior chamber occurred in Group 1 and Group 2 compared with significant differences ( χ2 = 2 1.86 94, P <0.01). Conclusion Preserving the anterior lens capsule is an effective method for the treatment of complicated retinal detachment associated with cataract. Silicone oil can be safely used as a vitreous cavity replacement in vitreoretinal surgery with intraocular lens implantation.