Pseudofakické odchlípení sítnice ve vztahu ke komplikacím operacekatarakty

Pseudophakic Detachment of the Retina in Relation to Complications of CataractSurgery

The authors made a retrospective study in a group of 14 patients operated in 1999on account of pseudophakic detachment of the retina (D.R.). They followed up riskfactors of development of D.R. in conjunction with complications of cataractsurgery. The investigated factors comprised patients´ sex and age, type of cataract operation and type of implanted lens, complications of cataract surgery, timeinterval between cataract surgery and the development of D.R., pre-operative andpostoperative visual acuity and type of operation of D.R.In the group there was a significant ratio of men (71.4 %), the mean age was 60.28years and 78.6 % of the patients were referred to our department. Phacoemulsification with implantation of IOL was made in 57 % of the patients, extracapsularextraction with implantation of IOL in 47 %. The authors did not find a significantdifference between the type of cataract surgery with regard to the developmentof D.R. A posterior chamber intraocular lens was implanted in 71% eyes of thegroup while an anterior chamber intraocular lens was used only in 29 % of theeyes in the group.Complications of cataract surgery were above all ruptures of the posterior capsule(64 %). Dislocation of the lens into the vitreous body during surgery was recordedonly in one case (7 %) a non-complicated operation of cataract was recorded in28 %, incl. one case (7 %) where D.R. was preceded by laser capsulotomy. The meantime interval between cataract operation and D.R. was 20.7 months. The visualacuity before surgery of D.R. was 0.24 while after surgery it was 0.31.In 50% patients a cryosurgical procedure was used in operation of D.R., pars planavitrectomy as the first operation of D.R. was used in 50 % of the group. Adherenceof the retina after the first operation wasachievedin 64.2 %eyes, after re-operationin 85.7 % eyes. The authors did not find a significant difference between the typeof cataract surgery and type of implanted lens as regards anatomical and functional results of surgery of D.R. Proliferative vitreoretinopathy and dysfunction ofthe photoreceptors were the main cause of anatomical and functional failure theoperation of D.R. in the group. The number of pseudophacic D.R. after lasercapsulotomy did not exceed the number of D.R. after non-complicated cataractsurgery in the investigated group.

Key words:
complications of cataract surgery, rupture of posterior capsule, pseu-dophakic detachment, cryosurgery, vitrectomy, PVR, dysfunction of photorecep-tors