摘要
目的观察白内障超声乳化吸除联合人工晶状体（IOL）植入手术后黄斑裂孔性视网膜脱离（MHRD）的发生率，并探讨影响其发生的相关因素。方法回顾性分析10076例白内障超声乳化吸除联合IOL植入手术患者13625只眼的临床资料，其中眼轴≥26．0mm或植入晶状体度数≤15．0D的高度近视白内障患者1228例1853只眼。所有患者手术前常规行裂隙灯显微镜、检眼镜及A或B型超声检查等检查。采用透明角膜切口或巩膜隧道切口行白内障超声乳化吸除联合IOL植入手术。手术后随访12～126个月，平均随访时间（48．2±31．1）个月。通过散瞳检查眼底和B型超声、光相干断层扫描（OCT）检查确诊是否发生MHRD，并对发生MHRD者相关危险因素进行分析。结果本组患者中，共有9例10只眼发生MHRD，占本组手术眼的0．073％。其中，6例7只眼为高度近视眼患者，高度近视眼MHRD的发生率为0．378％。MHRD的发生时间为手术后9～74个月，平均时间为38．5个月。累计风险度估计为0．16％（95％可信区间为0．05%～0．27％）。结论白内障超声乳化吸除联合IOL植入手术后MHRD的发生率为0．073%，高度近视眼MHRD的发生率为0．378％。手术前合并高度近视可能是影响MHRD发生的危险因素，其中，近视可能与MHRD紧密相关。
Objective To observe the incidence and related factors of macula hole retinal detachment （MHRD） after phacoemulsification cataract extraction and intraocular lens （IOL） implantation. Methods The clinical data of 10 076 patients （13 625 eyes） who underwent phacoemulsification cataract extraction and intraocular lens implantation were retrospectively analyzed. There are 1228 patients （1853 eyes） with high myopia. All the patients were examined by routine slit-lamp microscopy, ophthalmoscopy as well as A- or B-scan uhrasonography. The phacoemulsification cataract extraction with transparent cornea incision or scleral tunnel incision, combined with intraoeular lens implantation was performed in all the patients. The follow up was ranged from 12 to 126 months, with a mean of （48.2 ±31.1） months. The MHRD was confirmed by the examinations of the fundus, Bscan uhrasonography and optical coherence tomography. The incidence of postoperative MHRD and the risk factors were analyzed. Results 10/13 625 eyes （0. 073%） with MHRD were observed. 7/1853 high myopia eyes （0. 378%） with MHRD were observed. The occurrence time of MHRD was ranged from 9 to 74 months after surgery, with a mean of 38.5 months. The cumulative risk was estimated at 0.16% （95% confidence interval, 0.05% - 0.27%）. Conclusions The incidence of MHRD after phacoemulsifieation cataract extraction combined with intraocular lens implantation is 0. 073%. The MHRD incidence of high myopia eyes is 0. 378%. High myopia may be the risk factor for MHRD.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2011年第4期360-362,共3页
Chinese Journal of Ocular Fundus Diseases
