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[摘要]
目的：探讨在后节手术中合并前节疾病(白内障、青光眼、角膜病)联合手术的利与弊，并分析影响手术效果的危险因素。
方法：有针对性的分为A组增殖性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)，B组复杂性视网膜脱离(retinal detachment，RD)，为了便于对比，又将A组分为A1组：单纯玻璃体切割组； A2组：玻璃体切割+白内障摘除组； A3组：玻璃体切割+白内障摘除+人工晶状体植入术组。将B组分为B1组：单纯玻璃体切割组； B2组：玻璃体切割+白内障摘除组； B3组：玻璃体切割+白内障摘除+人工晶状体植入术组。
结果：手术的并发症为主要观察指标，A组为新生血管性青光眼，B组为手术复发或更严重的PVR形成。其并发症的发生率A3>A2>A1，A3明显高于A2和A1，均有统计学意义，A2>A1，但无统计学意义。B组三组的结果与A组三组相同。
结论：可能的情况下尽量不选择联合手术，如影响操作则选择非一期植入人工晶状体。
[Key word]
[Abstract]
AIM: To discuss the advantages and disadvantages of combined surgery, which consists of posterior segment diseases and anterior segment diseases(cataract, glaucoma, keratonosus), and analyze the hazards that may affect surgery.
METHODS: Group A: proliferative diabetic retinopathy(PDR), group B: complicated retinal detachment(RD). For comparison, group A was divided to group A1: vitrectomy; group A2: vitrectomy + cataract extraction; group A3: vitrectomy + cataract extraction + intraocular lens implantation. Group B was divided to group B1: vitrectomy; group B2: vitrectomy + cataract extraction; group B3: vitrectomy + cataract extraction+ intraocular lens implantation.
RESULTS: Surgery complications were the main outcome measures: neovascularity secondary glaucoma in group A and surgery recurrence or proliferative vitroretinopathy in group B. The incidence of complication: group A3>A2>A1, A3 was significantly higher than A2 and A1, and it was statistically significant, A2>A1, but it was not statistically significant. The results of group B were the same as group A.
CONCLUSION: Combined surgery will not be chosen if it is possible, and intraocular lens should not be implanted at once if the operation was influenced.
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