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 slitlamp microscopy, ophthalmoscopy as well as A- or B-scan ultrasonography. The phacoemulsification cataract extraction with transparent cornea incision or scleral tunnel incision, combined with intraocular lens implantation was performed in all the patients. The followup was ranged from 12 to 126 months, with a mean of （48.2plusmn;31.1）months. The MHRD was confirmed by the examinations of the fundus, B-scan ultrasonography 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 phacoemulsification cataract extraction combined with intraocular lens implantation is 0073%. The MHRD incidence of high myopia eyes is 0.378%. High myopia may be the risk factor for MHRD.
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.