Objective To investigate the results and complications of vitrectomy in the treatment of natural lens or intraocular lens dislocated into vitreous cavity combined with retinal detachment.Methods We retrospectively analyzed the clinical data of 26 eyes of 26 cases with natural lens or intraocular lens dislocated into vitreous cavity combined with retinal detachment who had undergone vitreoretinal surgery.Lens dislocation after blunt trauma was found in 7 eyes,and in other 19 eyes,natural lens or intraocular lens was dislocated during or after cataract surgery.The dislocated intraocular lens was removed through the limbal incision.The dislocated natural lens was removed by phacoemulsification in the vitreous cavity.The vitreous cavity was tamponaded with silicone oil in 14 eyes and C3F8 in other 12 eyes.16 eyes were treated with additional scleral buckling operation.The follow-up duration was 6-18 months,average (11.50 ±2.67) months.Results The dislocated natural lens and intraocular lens were all removed successfully in these 26 eyes.The total retinal reattachment was achieved in 23 eyes (88.46％),part reattachment was found in 2 eyes (7.69％),failure occurred in 1 eye (3.85％) due to severe proliferative vitreoretinopathy (PVR).The visual acuity was improved after operation in all eyes.Conclusion Vitrectomy for natural lens or intraocular lens dislocated into vitreous cavity combined with retinal detachment may achieve a high final retinal reattachment rate,but relatively bad functional results.%目的 探讨玻璃体切除术治疗晶状体或人工晶状体脱入玻璃体腔伴视网膜脱离的临床疗效和并发症.方法 对在我院进行标准睫状体平坦部三切口闭合式玻璃体切除术的26例(26只眼)晶状体或人工晶状体脱入玻璃体腔伴视网膜脱离者行回顾性分析.其中眼挫伤后晶状体脱位7只眼,白内障术中晶状体脱位和术后人工晶状体脱位19只眼.对人工晶状体脱入玻璃体腔者术中经角膜缘摘出人工晶状体,对晶状体脱入玻璃体腔者直接在玻璃体腔内行晶状体核超声乳化吸出.其中14只眼行硅油填充,12只眼行C3F8填充,16只眼联合巩膜外加压.术后随访6～18个月,平均(11.50±2.67)月.结果 26只眼均顺利摘出人工晶状体或超声乳化吸出玻璃体腔内晶状体核,视网膜最终完全复位23只眼(88.46％),部分复位2只眼(7.69％),失败1只眼(3.85％),后者系由病程长,增生性玻璃体视网膜病变(PVR)严重所致,术后大部分患者视力有不同程度的提高.结论 玻璃体切除术治疗晶状体或人工晶状体脱人玻璃体腔伴视网膜脱离可获得较好解剖效果,但功能恢复较差.
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