飞秒激光治疗移植物抗宿主病相关性白内障患者1例

One Case of Graft Versus Host Disease Related Cataract Surgery by Femtosecond Laser

目的:报告1例飞秒激光治疗移植物抗宿主病相关性白内障患者。方法:对一名男性异基因造血干细胞移植术后2年患者的白内障情况进行诊治并追踪。患者,男,29岁,异基因造血干细胞移植术后2年,双眼视力渐进性下降1年余,影响日常自理生活。眼部体征:Vod:0.06→0.2,Vos:CF/眼前(矫不应);NCT:R 11.2 mmHg,L 16.7 mmHg,泪液分泌试验:R 5mm/5min,L 2mm/5min,双眼结膜混合充血(++++),右眼晶体后囊下皮质呈砂锅底样混浊;左眼角膜中央实质层云雾状混浊并见大量新生血管,晶体全白色混浊。诊断:1.双眼并发性白内障,2.左眼角膜斑翳,3.慢性移植物抗宿主病,4.急性淋巴细胞性白血病,5.异基因造血干细胞移植术后,6.糖尿病。予右眼行白内障超声乳化摘除联合人工晶体植入术,左眼行飞秒激光辅助白内障超声乳化摘除联合人工晶体植入术。结果:患者术后视力Vod:0.4,Vos:0.04,目前患者生活自理已完全不受影响。结论:飞秒激光辅助白内障超声乳化摘除联合人工晶体植入术对特殊患者亦具有很高的安全性及手术效果。

Objective： To report I case of femtosecond laser used on patient with graft-versus-host disease-related cataract. Methods： To treat and follow up one patient with cataracts who had gone through allogeneic hematopoietic stem cell transplan- tation 2 years later. Male Patient, 29 years old, 2 years after allogeneic hematopoietic stem cell transplantation, binocular vi- sion decreased more than 1 year and affected his daily life. Eye signs： Vod： 0.06 → 0.2, Vos： CF （uncorrected）; NCT： R 11.2 mmHg, L 16.7 mmHg, Schirmer＇s test： R 5 mm / 5 rain, L 2 mm/ 5 min, conjunctival mixed hyperemia（＋＋＋＋）. The posterior subcapsular cataract of the right eye was casserole like opacity. The left central cornea was full of macula and a large number of neovascular vessels, with all-white opacity. Diagnosis： 1. Binocular cataracts, 2. I.eft corneal macula, 3. Chronic graft versus host disease, 4. Acute lymphoblastic leukemia, 5. Allogeneic hematopoietic stem cell transplantation, 6. Diabetes mellitus. Cataract phacoemulsification and intraocular lens implantation were used to treat the right eye, and femto second laser assisted cataract phacoemulsification and intraocular lens implantation were used to the left. Results.. The post-op erative visual acuity Vod： 0.4, Vos： 0.04, the current self care of patients has been completely unaffected. Conclusion： Fem- tosecond laser assisted cataract phacoemulsificaiton and intraocular lens implantation for special patients also has a high safety and surgical effect.