5-氟尿嘧啶联合皮质类固醇防治人工晶体植入术后后囊混浊的疗效观察

A Follow up Study on Preventing from Posterior Capsular Opacity after Intraocular Lens Implantation by 5 Fluorouracil with Corticosteroid

目的探讨简单易行的白内障囊外摘除（ｅｘｔｒａｃａｐｓｕｌａｒｃａｔａｒａｃｔｅｘｔｒａｃｔｉｏｎ，ＥＣＣＥ）加后房型人工晶体植入术后远期（半年至２年）后囊混浊（ｐｏｓｔｅｒｉｏｒｃａｐｓｕｌａｒｏｐａｃｉｔｙ，ＰＣＯ）的防治措施。方法对２８例（３１眼），其中外伤性白内障１６例（１６眼），并发性白内障６例（８眼），老年性白内障６例（７眼），行后房型人工晶体植入，术后第７天开始用５－氟尿嘧啶（５－ｆｌｕｏｒｏｕｒａｃｉｌ，５－Ｆｕ）结膜下注射，全程用５－Ｆｕ（４５ｍｇ），半年后随诊，按后囊混浊分级标准对疗效进行评价。结果本组３１只眼中０级（后囊透明）者２９眼占９３．５５％，Ⅰ级和Ⅱ级（后囊混浊）各１眼占６．４５％，即后囊混浊的发生率为６．４５％，明显低于其它报道（４０～５０％），而且所发生的２例后囊混浊未引起明显的视力下降，故有效防治率达１００％。结论５－Ｆｕ联合皮质类固醇局部应用是一种简便易行，安全有效的防治白内障术后后囊混浊的方法。

ObjectiveThis study was designed to find a way of preventing secondary posterior capsular opacity(PCO)which occurs a half to two years after extracapsular cataract extraction(ECCE)and intraocular lens implantation.Methods5 fluorouracil(5 Fu)and corticosteroid were injected subconjunctivally in 31 eyes (16 eyes with traumatic cataract,8 eyes with complicated cataract and 7 eyes with senile cataract)at 7 d to after ECCE.5 Fu (45mg) was used in the whole treatment.The effect of the operation was evaluated according to the degree of PCO.ResultsOf 31 eyes,29 eyes (93.55%) were 0 degree (posterior capsular transparant);the other two eyes (6.45%) were I degree and Ⅱ degree (PCO),respectively.The rate of PCO was only 6.45%,which was obviously lower than that of 40%—50% during 0.5 to 2 a after the prior treatment without 5 Fu and corticosteroid.The postoperative vision of the 2 cases of PCO was not significantly decreased.The rate of curative effect was therefore 100%.Conclusion5 Fu and corticosteroid injected subconjunctivally after ECCE is a safe and effective method to prevent the PCO of ECCE.