人工晶状体植入术后瞳孔膜形成的观察与处理

Clinical observation and management of pupil fibrous membrance formation after posterior chamber intraocular lens implantation.

目的 探讨各类白内障人工晶状体植入术后瞳孔膜形成的机制及处理方法。方法 对 14 5例术后瞳孔膜形成进行观察。Ⅰ级膜 96眼 ,采用地塞米松眶内注射联合散瞳治疗。Ⅱ级膜 49眼采用 5 FU联合地塞米松眶内注射及散瞳 ,随访 3～ 12月。结果 瞳孔膜 1周内大部分吸收 ,5例 15天吸收 ,除拒绝治疗的 3例外 ,无 1例复发。结论 瞳孔纤维膜的形成可能与血 房水屏障破坏和免疫反应有关。 5 FU联合地塞米松眶内注射及散瞳是治疗较严重瞳孔膜的有效方法。

To evaluate mechanism and management of pupil fibrous membrane formation after various cataract extraction and posterior chamber intraocular lens implantation.Method 145 cases of pupil fibrous membrance formation were observed,including 96 eyes of I grade fibrous membrane formation and 49 eyes of Ⅱ grade,and were treated with intraorbital injection of dexamethasone (DXM) combined mydriasis and 5-fluorouracil(5-Fu) and DXM combined mydriasis respectively,All of the cases have followed up for 3～12 months, Except the 3 patients who refused accepting this treatmemt.Results Fibrous membrane was absorbed within a week in 140 case, only 5 case,in the 15th day.No case had a relapse.Conclusion It is suggested that there be a close relevance between the fibrous membrane formation and breakdown of blood-aqueous barrier and immune response.5-Fu combined DXM intraorbital injection and mydriasis are an effective treatment of serious pupil fibrous membrane formation.