CAJ | 학술논문

目的探讨葡萄膜炎并发白内障的手术治疗效果.方法回顾性系列病例研究.选择2000年1月至2006年8月在中国医学科学院北京协和医院眼科诊治的51例(69只眼)葡萄膜炎并发白内障患者的手术资料,分析所选手术方式、术后视力、术后葡萄膜炎复发及并发症等情况.应用非参数Wilcoxon检验,对术前、后视力进行统计学分析.结果 64只眼(92.8%)施行白内障超声乳化摘除术,5只眼(7.2%)行白内障囊外摘除术.61只眼(88.4%)植人人工晶状体,8只眼(11.6%)未植入人工晶状体,其中6只眼是对侧眼已失明的单眼患者.38只眼(55.0%)术后末次随诊小孔视力≥0.5,较术前视力(仅1只眼的术前视力≥0.5,占1.4%)明显提高(Z=8.26,P＜0.001).术后19只眼(27.5%)出现前葡萄膜炎复发,其中18只眼是植入人工晶状体眼,5只眼前葡萄膜炎复发≥3次.术后24只眼(34.8%)因后囊膜混浊行YAG激光治疗,其中23只眼是人工晶状体眼,7只眼行至少2次钇铝石榴石激光治疗.结论手术治疗葡萄膜炎并发白内障的疗效较好,不植入人工晶状体可能更安全,术后并发症少,适用于对侧眼已失明的单眼患者.
목적 탐토포도막염병발백내장적수술치료효과.방법 회고성계렬병례연구.선택2000년1월지2006년8월재중국의학과학원북경협화의원안과진치적51례(69지안)포도막염병발백내장환자적수술자료,분석소선수술방식、술후시력、술후포도막염복발급병발증등정황.응용비삼수Wilcoxon검험,대술전、후시력진행통계학분석.결과 64지안(92.8%)시행백내장초성유화적제술,5지안(7.2%)행백내장낭외적제술.61지안(88.4%)식인인공정상체,8지안(11.6%)미식입인공정상체,기중6지안시대측안이실명적단안환자.38지안(55.0%)술후말차수진소공시력≥0.5,교술전시력(부1지안적술전시력≥0.5,점1.4%)명현제고(Z=8.26,P＜0.001).술후19지안(27.5%)출현전포도막염복발,기중18지안시식입인공정상체안,5지안전포도막염복발≥3차.술후24지안(34.8%)인후낭막혼탁행YAG격광치료,기중23지안시인공정상체안,7지안행지소2차을려석류석격광치료.결론 수술치료포도막염병발백내장적료효교호,불식입인공정상체가능경안전,술후병발증소,괄용우대측안이실명적단안환자.
Objective To evaluate the efficacy of surgical intervention of complicated cataract in patients with uveitis.Methods Fifty-one patients(69 eyes)with complicated cataract secondary to uveitis who had cataract surgery in Peking Union Medical College Hospital between January 2000 and August 2006 were retrospectively analyzed.Surgical procedures,visual outcome,postoperative recurrence of uveitis and complications were investigated.Results Phacoemulsification was performed on 64 eyes(92.8%),while extracapsular cataract extraction(ECCE)was performed on the remaining 5 eyes(7.2%).Posterior chamber intraocular lens(IOL)was implanted in 61 eyes(88.4%),while the remaining 8 eyes(11.6%)remained aphakic,6 of those were in patients who were blind in the other eye.At the final follow-up,38 eyes (55.0%)had a best corrected visual acuity of 0.5 or better,an improvement that was highly significant (Z=8.26.P＜0.001).Postoperative recurrence of anterior uveitis occurred in 19(27.5%)eyes,however,18 of them were pseudophakic,among which 5 eyes had 3 or more episodes of recurrence.Neodymium:YAG(Nd:YAG)laser posterior capsulotomy Wag performed in 24(34.8%)eyes,however,23 of them were pseudophakic,among which 7 eyes underwent at least two separate capsulotomies.Conclusions Surgical intervention of complicated cataract in patients with uveitis is effective and safe.In comparison with the pseudophakia group,less postoperative complications are found in patients without IOL implantation.Accordingly.it seems feasible that cataract extraction without IOL implantation is the procedure of choice for treating uveitis patients who are blind in the other eye.