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目的 观察玻璃体视网膜疾病伴有白内障需行玻璃体切除时保留晶状体前囊和后囊的临床反应和疗效.方法 30例(30眼)玻璃体视网膜疾病伴有白内障者,随机分成两组,每组15例(15眼).A组(保留晶状体后囊)行小切口白内障摘出后再行玻璃体切除,B组(保留晶状体前囊)行常规闭合式三通道手术,先在晶状体前囊下切除晶状体再行玻璃体切除术.结果 术后视力均有不同程度提高,术后1周,眼压升高者:A组4例(4眼),B组1例(1眼);虹膜后粘连者:A组5例(5眼),B组0例.术后1～2个月,虹膜后粘连者:A组15例(15眼)均出现程度不一的虹膜后粘连,9例因瞳孔闭锁,虹膜高度膨隆出现继发性青光眼;B组0例且眼压均正常.结论 玻璃体切除合并白内障保留晶状体前囊可以避免虹膜后粘连及其引起的继发性青光眼,并减轻了眼部组织的损伤.“,”Objective To observe and analyze the clinical reaction and effects of vitrectomy combined with cataract surgery retaining anterior or posterior lens capsule. Methods 30 eyes of 30 vitroretinopathy combined with cataract were divided into two groups randomly with 15 cases in each group. Group A were treated by vitrectomy followed by small-incision cataract surgery to retain posterior lens capsule. Surgical procedures in group B were lensectomy followed by vitrectomy with routine 3-passage closed operation.Results Postoperative visual acuity improved at various degrees. 4 cases in group A and 1 case in group B had elevated intraocular pressnre (IOP) at 1 week postoperatively. 5 cases in group A and none in group B had iris posterior synechia. 15cases in group A had iris posterior synechia at different degrees at 1 to 2 months postoperatively, 9 cases of which had secondary glaucoma due to atretopsia and iris bombe. No iris synechia was in group B and all cases in group B had normal IOP. Conclusions Vitrectomy combined with cataract surgery retaining anterior lens capsule can avoid iris posterior synechia and secondary glaucoma caused by synechia and minimize the damage to ocular tissues.