HSK合并白内障行超声乳化术后的疗效及临床用药观察

Effect and clinical medicine observation after phacoemulsification for herpes simplex keratitis with cataract

目的:观察单纯疱疹病毒性角膜炎(Herpes simplex keratitis,HSK)合并白内障患者行白内障超声乳化术后视力变化及术后应用抗病毒药物预防单纯疱疹病毒性角膜炎复发的疗效。方法:单纯疱疹病毒性角膜炎合并白内障22例22眼行白内障超声乳化+人工晶状体植入术,术后随机分为两组,治疗组给予口服阿昔洛韦及滴用更昔洛韦凝胶;对照组仅给予滴用更昔洛韦凝胶。观察术后视力变化情况;分析单纯疱疹病毒性角膜炎复发的情况。结果:术后6mo随访,治疗组和对照组视力均获得提高;治疗组无1例出现单纯疱疹病毒性角膜炎的复发;对照组也仅有1例于术后6mo复发,差异无显著性。结论:在抗病毒药物的保护下,>6mo未复发的单纯疱疹病毒性角膜炎不是白内障的手术禁忌,白内障手术能有效改善HSK合并白内障患者的视力;仅滴用更昔洛韦凝胶亦能有效预防白内障术后单纯疱疹病毒性角膜炎的复发。

AIM ： To research the vision changes after phacoemulsification for herpes simplex keratitis （HSK） with cataract, and the clinical effect of antiviral drugs in preventing HSK relapse as well. ~ METHODS： Twenty- two cases （22 eyes） with HSK combined cataract were treated by phacoemulsification and intraocular lens implantation, and then randomly divided into two groups. The patients in treatment group received aciclovir tablets and ganciclovir ophthalmic gel, those in control group received ganciclovir ophthalmic gel only. The vision changes after phacoemulsification were observed and the HSK relapse was analyzed. ~ RESULTS： After follow-up of 6 months, the visions of patients in both groups were improved. No relapse of HSK was found in the treatment group, and only one relapse of HSK was found in the control group after 6 months. There were no significant differences in therapy effects. ~ CONCLUSION： Under the protection of antiviral drug, cataract surgery can be applied to patients with HSK recurrence-free more than 6 months, and improve the visions effectively. Ganciclovir ophthalmic gel can effectively prevent the relapse of HSK after cataract surgery.