使用糖皮质激素患者白内障手术临床观察

Clinical observation of cataract surgery in patients with glucocorticoids-dependent

目的探讨长期使用糖皮质激素的白内障患者的手术治疗效果。方法回顾性分析2000年1月至2005年3月连续治疗的22例长期使用糖皮质激素的白内障患者的原发疾病、手术治疗效果和并发症。结果原发疾病包括风湿或类风湿性关节炎9例12只眼,系统性红斑狼疮8例10只眼,肾移植术后3例5只眼,皮肌炎1例1只眼,干燥综合征1例1只眼。按常规进行白内障超声乳化及折叠人工晶体植入术,术后裸眼视力在0.5以上者有25眼,3例患者术后发生严重的葡萄膜炎。结论长期使用糖皮质激素的白内障患者手术后应警惕发生严重的葡萄膜炎。

Objective To evaluate the results of cataract surgery in patients who had a long-term usage of glucocorticoids. Methods The primary diseases, outcome, and complications of the surgery were retrospectively analyzed in 22 cataract patients who had a long-term usage of glucocorticoids and treated in our department from January 2000 to March 2005. Results The primary diseases included rheumatic arthritis in 9 cases （ 12 eyes） , systemic lupus erythematosus in 8 cases （10 eyes） , renal transplantation in 3 cases （5 eyes） , dermatomyostitis in 1 case （1 eye）, and sjogren＇s syndrome in 1 case （1 eye）. All patients were routinely performed surgery of phacoemulcification and intraocular lens implantation. The postoperational vision was more than 0.5 in 25 eyes. Three cases suffered from severe uveitis after surgery. Conclusion Severe uveitis is likely to occur for patients who had a long-term usage of glucocorticoids and measures should be taken to reduce the complication.