摘要
Abstract
Objective To investigate the clinical features and surgical efficacy of pseudophakic retinal detach -ment.Methods The clinical data of 56 patients (56 eyes) with pseudophakic retinal detachment who were treated in our hospital between August 2010 and March 2013 were reviewed.There were 27 males and 29 females.Average age was 47.5 (range 7~77 years).The duration of retinal detachment at presentation varied from 2 days to 6 months.All patients were implanted with posterior chamber intraocular lens .The preoperative visual acuity was light perception to finger count in 34 eyes, 0.02 to 0.1 in 10 eyes, 0.1 to 0.2 in 6 eyes, and 0.2 to 1.0 in 6 eyes.Proliferative vitreo retinopathy ( PVR) grading was PVR stage B in 37 eyes, stage C1 to C3 in 16 eyes, and stage D in 3 eyes.Retinal tears were confirmed in 26 eyes before surgery (macular hole or macular hole overlapped with peripheral tears in 5 eyes).Thirty-three eyes had intact posterior capsule, while 23 eyes presented with incomplete posterior capsule or broken ciliary zonule (4 eyes with IOL dis-location).These patients were treated with scleral buckling with or without cerclage (9 eyes, 16.1%), simple gas tam-ponade (1 eye, 1.8%), or vitrectomy (46 eyes, 82.1%) with silicon oil tamponade (38 eyes, 67.9%) or C3F8 tampon-ade (8 eyes, 14.3%).IOL was taken out in 5 eyes during vitrectomy surgery .Results The follow-up period ranged from 3 months to 2 years.The final BCVA was light perception to finger count in 25 eyes, 0.02 to 0.1 in 16 eyes, 0.1 to 0.2 in 8 eyes, and 0.2 to 1.0 in 7 eyes.Among 9 eyes that treated with scleral buckling , re-attachment was achieved in 8 eyes.In 1 eye we turned to vitrectomy with silicon oil tamponade later because of incomplete attachment .The eye treated with simple gas tamponade successfully achieved re-attachment.In 38 eyes received vitrectomy and silicone oil tamponade , anterior chamber leakage was observed in 3 eyes within 2 weeks.Silicone oil was partially removed through immediate ante-rior chamber penetration , but complete removal was finished at three months later .By the end of the follow-up, silicone oil was removed in totally 12 eyes.Retinas remained attached in these eyes except that 1 eye suffered a recurred detachment . Four out of 26 silicon oil filled eyes showed incomplete attachment ,but removal of the silicone oil or other severe complica-tions were not found.In 8 eyes received vitrectomy and C3F8 tamponade, retinas remained attached in 7 eyes, and in 1 eye the attachment was incomplete and silicon oil filling was performed later .Overall, 51 eyes (91.1%) achieved complete re-attachment , while 24 eyes remained silicone oil filled .Conclusion The surgical strategies for pseudophakic retinal de-tachment are usually complicated with certain adverse factors such as low rate of tears location , capsule fibrosis or disturb-ance of IOL.Thus, treatment should be personalized in order to accomplish best outcomes for patients .关键词
人工晶状体眼/视网膜脱离Key words
Pseudophakic eye/Retinal detachment
