玻璃体切除术后交感性眼炎的临床分析

Clinical analysis of sympathetic ophthalmia after vitrectomy

目的 分析玻璃体切除术后交感性眼炎的临床特征.方法 回顾性分析璃体切除术后交感性眼炎13例的临床资料.结果 发生交感性眼炎的时间距最后一次玻璃体手术时间为10 d～2年,4个月以内者8例（61.5％）,临床表现以视力下降为主,其次为眼痛、眼前黑影、视物变形.发病时交感眼视力为0.04 ～0.6,激发眼视力为无光感～数指.4例交感眼有渗出性视网膜脱离.所有患者经糖皮质激素治疗后交感眼和激发眼视力均有不同程度恢复.3例因激发眼视力完全丧失而行眼球摘除术.结论 玻璃体切除术后交感性眼炎发生率为0.29％;大多发生在手术后4个月以内;术中联合晶状体手术、巩膜外冷凝、术前存在眼外伤和其它手术史,增加发生交感性眼炎的危险.

Objective To analyse the chnical manifestations of sympathetic ophthalmia after pars plana vitretomy.Methods Retrospective study was performed in 13 cases with sympathetic ophthalmia who had undergone pars plana vitrectomy.Results The interval time from the last vitrectomy to the occurrence of sympathetic ophthalmia ranged from 10 days to 2 years,8 cases （61.5%） occurred within 4 months.The decrease of visual acuity took the first place in clinical manifestations,followed by opthalmalgia,spotted vision and visual distorsion.The visual acuity was from 0.04 to 0.6 in sympathetic eyes,and no light perception to counting finger in the exiting eyes.4 sympathetic eyes had exudative retinal detachment.The visual acuity increased partly in the sympathetic eyes and the exiting eyes after treatment with steroid.Three patients had undergone enucleation of exiting eyes because of total loss of visual acuity.Conclusion The incidence of sympathetic ophthalmia after vitrectomy is low,about 0.29%.It happened mainly within 4months after vitrectomy.Vitrectomy combined with lens-surgery,scleral buckling with cryopexy,preexisted eye injury and others surgeries,are the risk factors of sympathetic ophthalmia after vitrectomy.