肝素表面处理人工晶状体在并发性白内障手术中应用疗效观察

To observe the clinical effect of heparin surface-modified intraocular lens implanted in complicated cataracts

目的探讨肝素表面处理人工晶状体在并发性白内障患者手术中应用的疗效。方法106例(152只眼)并发性白内障患者中随机抽取98只眼为研究组(A),植入HQ-201HEP型肝素表面处理人工晶状体;54只眼为对照组(B),植入MA-60MB型人工晶状体。比较术后视力、眼压、前房闪辉、房水细胞、虹膜后粘连、后囊膜混浊等结果。结果研究组(A)中98只眼有前房闪辉30只眼(30.6%),房水细胞阳性26只眼(26.5%),虹膜后粘连17只眼(17.3%),后囊膜混浊2只眼(2.04%),高眼压2只眼(2.04%)。而对照组(B)54只眼有前房闪辉42只眼(77.8%),房水细胞阳性43只眼(79.6%),虹膜后粘连24只眼(44.4%),后囊膜混浊7只眼(12.7%),高眼压6只眼(11.1%)。结论临床研究发现肝素表面处理人工晶状体在减轻眼内炎症反应、异物反应、细胞在人工晶状体表面沉着(前房闪辉、房水细胞、虹膜后粘连、后囊膜混浊)等方面优于对照组,尤其对于有葡萄膜炎病史、青光眼术后、局部和全身应用类固醇激素者尤为适合,可减轻高眼压和前房出血的发生。

Objective To evaluate the results of heparin surface-modified intraocular lens implanted in complicated cataracts. Methods In 152 eyes of 106 patients with complicated cataract ,98 eyes（group A） received HQ-201HEP heparin surface-modified intraocular lens and 54 eyes received MA-60MB intraocular lens（ group B） at random. The postoperative visual acuity, intraocular pressure, anterior chamber reaction and posterior capsular opacity were analyzed between the two groups. Results During the follow-up period, aqueous flare were observed in 30 eyes of group A （30.6% ）, compared with 42 eyes in group B（77.8% ） ; aqueous cells were observed in 26 eyes of group A （ 26.5% ）. ,43 eyes of group B（79.6% ） ;iris posterior synechiae occurred in 17 eyes of group A（ 17.3% ） ,compared with 24 eyes in group B （44.4%） ; posterior capsular opacity developed in 2 eyes of group A（ 2.04% ） ,7 eyes of group B（ 12.7% ）. The ocular hypertension were observed in 2 eyes of group A compared with 6 eyes in group B. Conclusion The heparin surface-medifled intraocular lens are superior than the control intraocular lens in diminishing anterior chamher inflammation, foreign body reaction and the cellar precipitation which includes aqueous flare, aqueous cells, iris posterior synechiae and posterior capsular opacity. The use of heparin surface-modified intraocular lens can reduce the incidence of ocular hypertension and hyphema ,especially for patients who have a history of uvitis ,anti-glaucoma operation and using glucocorticoid topically or systemically.