葡萄膜炎并发白内障手术治疗的临床观察

Clinical observation of surgical treatment for uveitis complicated with cataract

目的 探讨葡萄膜炎并发白内障手术治疗的方法和临床效果。方法 33例（33眼）葡萄膜炎并发白内障患者行超声乳化人工晶状体植入术治疗,术前和术后给予泼尼松联合环磷酰胺治疗。术后观察视力、眼压、并发症以及葡萄膜炎复发等情况。术后随访6个月。结果 33眼术后视力均有不同程度提高。术后最佳矫正视力≤0.1者3眼（9.09%）,〉0.1-〈0.5者11眼（33.33%）,0.5-〈1.0者14眼（42.42%）,≥1.0者5眼（15.15%）。术后并发症包括后发性白内障2眼（6.06%）,虹膜轻微后粘连6眼（18.18%）,白细胞数量轻度降低1例（3.03%）。术后眼压均控制在正常范围内。随访期内未见葡萄膜炎复发。结论 葡萄膜炎并发白内障行白内障超声乳化人工晶状体植入术,术前和术后给予小剂量糖皮质激素联合环磷酰胺治疗效果较好,便于临床应用。

Objective To discuss the clinical methods and efficacy of surgical treatment for uveitis complicated with cataract.Methods Thirty-three eyes of 33 uveitis cases with complicated cataract were treated with phacoemulsification and intraocular lens implantation,in the pre-operation and post-operation all cases were treated with glucocorticoid and cyclophosphamide.The visual acuity,intraocular pressure,complications and inflammation of uveitis were observed after operation.The patients were followed-up 6 months Results Postoperative visual acuity of 33 eyes were improved in different extent,the postoperative best corrected visual acuity was ≤0.1 in 3 eyes（9.09%）,〉0.1-〈0.5 in 11 eyes（33.33%）,0.5-〈1.0 in 14 eyes（42.42%）,≥1.0 in 5 eyes（15.16%）.The postoperative complications included after-cataract in 2 eyes（6.06%）,posterior synechia of iris in 6 eyes（18.19%）and the mild decrease of white blood cells number in 1 case（3.03%）.The postoperative intraocular pressure was normal.There was no recurrence of uveitis in the follow-up period.Conclusion The preoperative and postoperative giving small doses glucocorticoid combined with cyclophosphamide in phacoemulsification and intraocular lens implantation for uveitis complicated with cataract is safe and convenient to be used in clinical.