肝素修饰人工晶体植入在抗青光眼术后白内障超声乳化术中的应用

The clinical study of implantation of heparin-surface-modified foldable intraocular lens in cataract after glaucoma surgery

目的观察肝素表面修饰折叠型人工晶体植入对抗青光眼术后白内障超声乳化吸除术后前房炎症反应的影响。方法对60例（88眼）抗青光眼术后白内障患者施行超声乳化吸除术，所有病例随机植入肝素表面修饰折叠型人工晶体或蓝光滤过折叠型人工晶体。应用激光闪光细胞检测仪（Laserflarecellmeter，LFCM）测量并比较术前及术后1天、7天、30天及90天房水的平均闪辉值，以评价前房炎症反应。并观察术前后的视力、眼压及滤过泡和角膜内皮计数情况。结果（1）术前，二组患者房水闪辉值没有显著性差异，植入肝素表面修饰折叠型人工晶体者，手术后7天内的房水闪辉值均明显低于蓝光滤过折叠型人工晶体植入组，而术后30、90天时两种人工晶体植入者之间差异无显著性。两组术后视力均明显提高，眼压控制稳定，角膜内皮功能正常。结论抗青光眼术后白内障手术后眼血一房水屏障功能受损，植入肝素表面修饰折叠型人工晶体能显著减轻白内障术后短期内的炎症反应，增加了手术安全性。

Objective To observe the inflammation in anterior chamber after phacoemulsification with implantation 2 types of foldable intraocular lens （IOL） in cataract patients after glaucoma surgery. Methods The phacoemulsification was performed in 88 eyes of 60 cataract patients after glaucoma surgery and foldable IOL and sigle-piece acrylic UV block foldable IOL were implantated randomly. The aqueous humor flare value was examined preoperatively and on day 1,7,30 and 90 after surgery with a laser flare cell meter. Visual acutity（VA）,filter bleb,introcular pressure（IOP） and corneal endothelium was examined. Results Before surgery, there was no significiant difference between 2 groups. Flare was significiantly lower in patients with implantation of heparin-surface-modified IOL on day 7 postoperatively than patients with implantation of single-piece acrylic UV block foldable IOL, there was no significiant difference on day 30,90 postoperatively. VA, filter bleb and IOP was well in all patients postoperatively, the counts of corneal endothelium was in normal range. Conclusions The blood-aqueous barrier was damaged in patients after glaucoma surgery. The inflammation in anterior chamber can be reduced with implantation of heparin-surface-modified IOL.