葡萄膜炎并发性白内障手术治疗应重视的问题

Focused Problems during Cataract Surgery Complicated with Uveitis

目的：探讨葡萄膜炎并发性白内障手术过程及术后治疗应重视的问题。方法：对2002年6月至2007年6月收治的视力≤0．2的86例（89眼）葡萄膜炎并发性白内障患者进行白内障切除，79眼人工晶体植入治疗的临床资料进行分析。结果：术中发现47眼前后囊膜混浊，其中35眼作后极部撕囊术；虹膜后粘连45眼，瞳孔膜闭5眼；4眼炎症持续两月以上；黄斑部水肿13眼；后发障25眼。术后3月除4眼视力无提高外，〈0．2者17眼，0．2～0．4者28眼，〉10．5者40眼；手术治疗后视力提高有显著性差异（P〈0．01）。结论：对葡萄膜炎并发性白内障患者，只要术前仔细检查，严格掌握手术指征，提高手术技巧，有效地控制术后葡萄膜炎症，可以使大部分患者获得更好的视力。

Objective： To investigate the problems which should be focused during the cataract surgery complicated with uveitis. Methods： To study the clinical data of 86 patients with 89 eyes（ preoperative visual acuity of all surgical patients was below 0. 2） who had been undergone cataract surgeries and partly（79 eyes） implanted IOLs （intraocular lens） between January 2001 and December 2006 retrospectively. Results： During the intraoperations, 47 eyes had been found to have anterior and posterior capsular opacifications, 35 eyes had been treated with posterior capsulorhexis . The cases with posterior synechiae and membranaceous pupils were 45 and 5 respectively,4 eyes had inflamation lasted over two month safter operation 13 eyes appeared macular edema while 25 eyes PCO （ posterior capsular opacification ）. The visual acuity in three months were as following： no improved 4 eyes, 17 eyes were below 0. 2, 28 eyes were between 0. 2 and 0. 4, 40 eyes were above 0. 5. The sight improving was statistically significant （ P 〈 0.01 ）. Conclusion： As long as examining carefully, being strict on operative indications as well as improving surgical techniques and effectively controlling uveitis, most cataract cases complicated to uveitis will beresuhed in hatter vision.