超声乳化人工晶体植入治疗葡萄膜炎并发白内障的临床效果

Clinical observation of phacoemulsification and intraocular lens implantation treatment for uveitis complicated cataract

目的探讨超声乳化白内障吸除人工晶状体植入术治疗葡萄膜炎并发白内障的临床效果。方法回顾性分析经临床确诊的59例(68眼)葡萄膜炎并发白内障患者临床资料,均行超声乳化白内障吸除人工晶状体植入术,统计分析病因、手术前后视力改善情况、术前使用皮质类固醇激素对治疗效果的影响及术后并发症发生情况等。结果术后患者视力均得到提高,术后最佳矫正视力(BCVA)>0.5为29眼,占42.65%。手术后的视力改善与手术前比较差异具有统计学意义(P<0.01)。全身使用了皮质类固醇激素治疗者34眼,患者的视力恢复明显劣于术前未用激素治疗者(P<0.01)。术后11例患者发生并发症(18.64%)。结论超声乳化白内障吸除人工晶状体植入术治疗葡萄膜炎并发白内障临床效果较好,术中处理得当能够显著提高术后视力和减少葡萄膜炎复发。

Objective To observe the therapeutic effect of phacoemulsification and intraocular lens implantation in patients with uveitis combined with cataract. Methods We collected 59 cases of patients（ 68 eyes） with uveitis and cataract admitted and treated in our hospital,treated with phacoemulsification and intraocular lens implantation after the operation. The causes,visual acuity before and after surgery,the effect of steroid treated patients before operation and the postoperative complications were analyzed.Results After cataract surgery,all cases had improved visual acuity,postoperative best corrected visual acuity（ BCVA） of 0.5 eyes was 29,accounting for 42.65% after surgery compared with preoperative visual acuity improved with statistical difference（ P 0.01）.The effect of preoperative hormone therapy（ 34 eyes） was significantly worse than that of nonsteroidal treated patients before operation（ P0.01）. Complications occurred in 11 patients（ 18.64%）. Conclusion Phacoemulsification and intraocular lens implantation can improve visual acuity in patients with uveitis complicated cataract and restore physiologic round pupil as much as possible during operation. Retaining posterior capsule can significantly improve postoperative vision and reduce uveitis recurrence.