摘要:
目的 探讨超声乳化白内障吸出联合人工晶状体植入治疗视网膜色素变性合并白内障的疗效.方法 回顾性研究.对2012年1月至2016年12月在乐山市人民医院眼科确诊为原发性视网膜色素变性合并白内障患者给予超声乳化白内障吸出联合人工晶状体植入术52例(101眼)患者的临床资料进行回顾性分析.所有患者治疗前后均进行最佳矫正视力、眼压、裂隙灯前节检查、睫状肌麻痹下眼底检查以及光学相干断层扫描检查.白内障手术均顺利完成,术后随访3 ~ 12(5.09±2.20)个月.患者手术前、手术后各指标的比较用配对t检验,视力提高幅度与黄斑厚度的相关关系采用Pearson相关检验.结果 101眼患眼最佳矫正视力由术前0.12±0.09提高至术后0.21±0.16,差异有统计学意义(t=-8.016,P=0.000).术后视力与黄斑厚度有明显相关性:对于黄斑囊样水肿及黄斑前膜,术后视力提高行数和黄斑厚度呈负相关(r=-0.866,P=0.001),对于黄斑萎缩,两者呈正相关(r=0.928,P=0.000).2眼在白内障术后出现前囊膜收缩,2眼出现继发性高眼压,给予前囊膜放射状切开、药物控制眼压平稳后,视力提高且长期趋于稳定.结论 超声乳化白内障吸出联合人工晶状体植入术可以提高患者视力,是治疗视网膜色素变性合并白内障安全有效的方法.%Objective To investigate the efficacy of phacoemulsification combined with intraocular lens implantation in the treatment of retinitis pigmentosa complicated with cataract.Methods A retrospective study was conducted in 52 patients (101 eyes) who admitted in Leshan People's Hospital from January 2012 to December 2016 after diagnosed with primary retinitis pigmentosa combined with cataract and underwent phacoemulsification combined with intraocular lens implantation,and then the clinical data were retrospectively analyzed.All patients were examined for the best corrected visual acuity (BCVA),intraocular pressure,slit lamp anterior segment examination,fundus examination under cycloplegia and optical coherence tomography before and after treatment.The preoperative and postoperative variables were compared by paired t-test,and the correlation between visual acuity and the macular thickness was analyzed by Pearson correlation test.Results Cataract surgery was completed successfully,and all patients were followed-up for (3-12) months,with an average (5.09 ± 2.20) months.The average BCVA of 101 eyes was increased from (0.12 ± 0.09)before surgery to (0.21 ± 0.16) after surgery,and the difference was statistically significant (t =-8.016,P =0.000).Postoperative visual acuity was significantly correlated with macular thickness.Furthermore,there was a negative correlation of macular thickness with macular cystoid edema,macular epiretinal membrane and visual acuity (r =-0.866,P =0.001),but a positive correlation with macular atrophy (r =0.928,P =0.000).Unfortunately,anterior capsule contraction occurred in 2 eyes after cataract surgery,and secondary intraocular hypertension appeared in 2 eyes.Visual acuity was improved and stable for a long time after radial incision of anterior capsule and medication control of intraocular pressure.Conclusion Phacoemuisification combined with intraocular lens implantation can improve the vision of patients,and is a safe and effective method for the treatment of retinitis pigmentosa complicated cataract.