超声乳化人工晶状体植入治疗葡萄膜炎并发性白内障

Observation on phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis

摘要:

目的：探讨白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障的手术疗效。

方法：本研究采用系统性回顾研究，选取2015-01/12在南京军区南京总医院眼科诊断为葡萄膜炎并发性白内障的患者57例57眼，所有患者均行白内障超声乳化联合人工晶状体植入术，对患者的术中并发症，术后效果及并发症情况进行回顾分析。对手术前后视力进行非参数Wilcoxon检验。

结果：所选患者超声乳化术中发生虹膜出血21眼(37%)，后囊膜破裂4眼(7%)，人工晶状体无法植入4眼(7%)，术后裸眼视力获得不同程度提高，术前裸眼视力≥0.1者8眼(14%)，术后3mo裸眼视力≥0.1 者42眼(74%)，差异有统计学意义(Z=23.42，P<0.001)。术后1d发生角膜水肿17眼(30%)、葡萄膜炎2眼(4%)、高眼压1眼(2%)，术后1wk发生角膜水肿3眼(5%)，术后1mo发生葡萄膜炎1眼(2%)，术后3mo发生角膜水肿1眼(2%)、葡萄膜炎2眼(4%)、高眼压1眼(2%)、后发性白内障3眼(5%)。

结论：白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障，术后效果好，并发症少。

Abstract:

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis.

METHODS: Retrospective study. A total of 57 cases(57 eyes)with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non-parametric Wilcoxon test.

RESULTS: Iris were bleed in 21 eyes(37%), 4 eyes(7%)with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes(7%). The uncorrected visual acuity(UCVA)was significantly increased after surgery. The UCVA of 8 eyes(14%)were 0.1 or better before surgery, and the UCVA of 42 eyes(74%)were 0.1 or better 3mo after surgery, the difference was statistically significant(Z=23.42,P<0.001). The corneal edema(17 eyes, 30%), uveitis(2 eyes, 4%)and intraocular hypertension(1 eyes, 2%)were appeared in postoperative 1d. The corneal edema(3 eyes, 5%)was appeared in postoperative 1wk. The uveitis(1 eyes, 2%)was appeared in postoperative 1mo. The corneal edema(1 eyes, 2%), uveitis(2 eyes, 4%), intraocular hypertension(1 eyes, 2%)and after-cataract(3 eyes, 5%)were appeared in postoperative 3mo.

CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.