人工晶体悬吊术后继发性色素播散综合征和色素性青光眼临床分析

SECONDARY PIGMENT DISPERSION SYNDROME AFTER INTRAOCULAR LENS VENTROFIXATION AND PIGMENTARY GLAUCOMA:A CLINICAL ANALYSIS

目的了解人工晶体悬吊术后继发性色素播散综合征和色素性青光眼的临床特征,探讨其治疗方法。方法行后房型人工晶体(Acrysof一片式折叠式人工晶体)悬吊术病人29例30眼,术前、术后均行视力、眼压、裂隙灯显微镜、前房角镜、超声生物显微镜(UBM)、眼底及视野检查,术后随访3～12个月。结果 29例病人30眼人工晶体悬吊术后眼前段色素播散表现为:未出现典型的角膜后色素沉着(Krukenberg色素梭),均出现中度以上(>ScheieⅡ级)小梁网色素颗粒沉积,所有人工晶体表面均有色素颗粒沉着,所有病例均存在虹膜震颤;9例病人10眼虹膜后凹,4例4眼UBM显示存在反向瞳孔阻滞,7例7眼术后眼压升高,平均(3.68±0.43)kPa。结论人工晶体悬吊术后继发性色素播散综合征主要表现为不同程度眼前段色素播散,继发色素性青光眼在色素播散综合征基础上出现眼压升高,需要给予适当治疗。

Objective To observe the clinical features of secondary pigment dispersion syndrome(PDS) after intraocular lens(IOL) ventrofixation and pigmentary glaucoma(PG) as well as their therapy.Methods IOL ventrofixation was performed in 29 cases(30 eyes).The vision,intraocular pressure(IOP),slit lamp microscopy,gonioscopy,ultrasound biomicroscopy,eyeground and visual field examinations were carried out before and after surgery.A follow-up of 3-12 months was conducted posto-peratively.Results No typical posterior corneal pigmentation(Krukenberg spindle) was found after surgery,all showed above-moderate-degree(>Scheie grade Ⅱ) pigment granule deposition that was seen on the surface of IOL,and pupillary athetosis,10 eyes had concave iris,ultrasound biomicroscopy(UBM) showed four eyes had reverse pupillary block.High IOP was detected in seven eyes,with an average of(3.68±0.43)kPa.Conclusion The main manifestation of secondary PDS after IOL ventrofixation is pigment granule dusting in the anterior segment of the eye.The characteristics of secondary pigmentary glaucoma are increased IOP that should be treated appropriately.