Objective To observe the clinical characteristics and therapeutic effect of aphakic retinal detachment (ARD) eyes and pseudophakic retinal detachment (PPRD) eyes.Methods The clinical data of 805 patients,including 321 ARD and 484 PPRD eyes were retrospectively analyzed.The patientsprime;visiual acuity, refraction, intraocular pressure were examined, and the patients also underwent slit lamp microscopy and direct and (or) indirect ophthalmoscopy.The preoperative bestcorrected visual acuity (BCVA) was between light perception (LP) and 0.6.Mainly according to the PVR grade and retinal holes position to take the scleral buckling or vitrectomy combined with scleral buckling. The 805 eyes were divided into 1995-1999 group (243 eyes) and 20002007 group (562 eyes) according to operative time.The follow-up ranged from 3 to 25 months, with an average of 12.3 months.The success standard of surgery was set as anatomic retinal reattachment and the last follow-up time was considered as the judgment time.The surgical complications were recorded at each followup time points. The composition of PPRD,the visual acuity,ocular lesions, surgical methods and results before operation and visual acuity after operation in two groups were analyzed and compared by MantelHaenszel chisquare test. Results The average interval from lens extraction to RD occurrence was 15.4 months in PPRD eyes and 39.1 months in ARD eyes. The final total anatomic success rate was 95.9%, and was 93.5% in the scleral buckle eyes and 97.2% in vitrectomy eyes.The BCVA was better than 0.3 after operation only in 11.9% of the 805 patiens,and the visual acuity increased more than 2 lines in 67.3%. Compared with the ARD eyes,early onset, high proportion of total posterior vitreous detachment,severe PVR,wide RD range,low detection rate of retinal hole and low antomic success rate were found in PPRD eyes.Compared with the 1995-1999 group,the proportion of vitreous surgery,anatomic success rate and better visual acuity were found in 2000-2007 group.Conclusions The ocular lesions of ARD and PPRD is more complicated,the therapeutic effect are improving in recent years.
Objective To evaluate the visual results,surgical tec hnique and safety of secondary intraocular lens (IOL) implantation in aphakic eyes following vitrectomy and lensectomy for complicated ocular trauma or retinal detachment． Methods The clinical records of 3 2 cases (32 eyes),received these surgeries during November 1996 and December 1999,were reviewed retrospectively.During the secondary operation，intraocular infu sion through the pars plana was performend and the type of IOL was chosen based on the integrity of lens capsule. Results The study included 30 eyes suffering from trauma (foreign bodies in 15 eyes,penetrating injury with traumatic endophthalmitis and with vitreous hemorrhage in 6 eyes respectively, blunt trauma with lens dislocation in 3 eyes),and 2 eyes with primary retinal detachment.Those eyes all received vitrectomy,lensectomy,and/or remova l of foreign bodies and corneal suture.The interval of two operations ranged from 1 to 16 months with an average of 6.8plusmn;3.7 months.Posterior chamber IOL was implanted in the ciliary sulcus in 25 eyes with a whole or 2/3 of lens capsule,trans scleral suture fixation of IOL in 5 eyes,anterior chamber IOL and IOL with artificialiris in one eye respectively.Silicone oil was removed in 5 eyes duri ng the secondary operation.Post-operative visual improvement was achieved in 29 eyes.Main complications were corneal edema and low intraocular pressure after operation. Conclusion Intraocular infusion and proper IOL implantation during the secondary operation following vitrectomy can provide selected aphakic eyes with better visual recovery. (Chin J Ocul Fundus Dis, 2001,17:96-98)