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类风湿关节炎患者晶状体超声乳化及人工晶状体植入术 被引量:1

A study of phacoemulsification and intraocular lens implantation on rheumatoid patients
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摘要 目的评价类风湿关节炎患者白内障晶状体超声乳化吸出及人工晶状体植入术的效果,探讨类风湿关节炎活动性指标与术后前房反应的关系。方法类风湿关节炎活动性指标不同的白内障22例(22眼),术后1周、1个月、3个月测量房水闪光和细胞计数值。结果手术无并发症发生。术后除1例老年黄斑变性外,其余患者矫正视力≥0.6,术前房水闪光均值为(1.7±0.5)pc/ms,细胞计数均值为(0.5±0.08)num/mm3,术后1周、1个月、3个月的房光闪光均值分别为(14.4±2.0)pc/ms,(5.8±1.4)pc/ms,(2.1±0.4)pc/ms,细胞计数值分别为(10.7±2.1)num/mm3,(4.5±1.2)num/mm3,(0.7±0.07)num/mm3,3个月时二者均降至术前水平。术后前房反应与术前类风湿因子滴度、血沉、C反应蛋白、葡萄糖6磷酸异构酶、抗环瓜氨酸肽抗体等指标之间无统计学意义的相关性。结论类风湿关节炎的白内障患者行白内障手术安全有效;术后前房反应的程度和持续时间与既往病情活动度无关。 Objective To assess the treatment results of phacoemulsifieation and intraocular lens implantation (PHACO ± IOL) on rheumatoid arthritis (RA) patients, and discuss the influence of preoperative activity of RA on early postoperative anterior chamber inflammation. Methods PHACO + IOL was performed on 22 eyes (22 according to normal procedures. All the patients had been followed up for about 3 months. Anterior chamber flare and ceils values were measured with laser flare-cell meter ( Kowa FC 2000,Japan) preoperatively and 1 week, 1 month , 3 months postoperatively. Results All eyes except one with age related macular degeneration acquired postoperative visual acuity of 0. 6 or better and no operative complications remained. The mean value of flare and cells in 22 eyes was 1.7 ± 0. 5 pc/ms, 0.5 ± 0. 08 num/ mm^3 respectively. Flare values of 1 week, 1 month and 3months postoperatively were 14.4 ± 2.0 pc/ms, 5.84 ± 1.4 pc/ms and 2.1 ± 0. 4 pc/ms respectively. Ceils values of 1 week, 1 month and 3 months postoperatively were 10.7 ± 2.1 num/mm^3 , 4.5 ± 1.2 num/mm^3 and 0. 7 ± 0.07 num/mm^3 respectively. Inflammation in anterior chamber 3 months postoperative decreased to preoperative level. The extent of inflammation in anterior chamber after surgery was not related to ESR, CRP, GPI, CCP and RF. Conclusion Intraocular lens implantation is basically a safe procedure for patients with rheumatoid arthritis. Inflammatory reaction in anterior chamber after phacoemulsification with foldable intraocular lens implantation is not related to preoperative activity of RA.
出处 《眼外伤职业眼病杂志》 2009年第4期267-270,共4页 Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries
关键词 白内障 晶状体 超声乳化 晶状体 人工 炎症 类风湿关节炎 phacoemulsification intraocular lens rheumatic arthritis
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参考文献15

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同被引文献9

  • 1Petris CK, Almony A. Ophthalmic manifestations of rheu- matologic disease: diagnosis and management. Mo Med, 2012 , 109:53 - 58.
  • 2Aletaha D, Negi T, Silman AJ, et al. 2010 Rheumatoid ar- thritis classification criteria: an American College of Rheumatology/European League Against Rheumatism col- laborative initiative. Ann Rheum Dis,2010, 69 : 1580 - 1588.
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  • 4Hogan M J, Kimura GJ, Thygeson P. Signs and symptoms of uveitis. Am J Ophthalmol,1959,47 : 155 - 170.
  • 5Chiu Y, Ostor A J, Hammond A,et al. Access to the next wave of biologic therapies (Abatacept and Tocilizumab) for the treatmemant of rheumatoid arthritis in England and Wales. Clin Rheumatol,2012, 31:1005 - 1012.
  • 6Obstbaum SA. The Binkhorst Medal Lecture. Biologic re- lationship between poly (methylmethacrylate) intraocular lenses and uveal tissue. J Cataract Refract Surg, 1992, 18:219-231.
  • 7Chee SP, Ti SE, Sivakumar M, et al. Postoperative in- flammation : Extracapsular cataract extraction versus phacoemulsification. J Cataract Refract Surg, 1999,25 : 1280 - 1285.
  • 8Matsuo T, Fujiwara M, Matsuo N. Inflammation after cataract extraction and intraocular lens implantation in pa- tients with rheumatoid arthritis. Br J Ophthalmol, 1995, 79 : 549 - 553.
  • 9Mohammadpour M, Jafarinasab MR, Javadi MA. Out- comes of acute postoperative inflammation after cataract surgery. Eur J Ophthalmol , 2007, 17 : 20 - 28.

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