医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2014年
17期
26-27
,共2页
糖尿病%白内障%前房反应
糖尿病%白內障%前房反應
당뇨병%백내장%전방반응
diabetes%cataract%surgery%inflammation
目的：探讨糖尿病患者白内障术后前房反应的发病特点及处理方法。方法：回顾性分析并总结我院13例13眼糖尿病患者白内障超声乳化联合人工晶状体植入术后出现前房反应的临床资料﹑治疗情况及随访结果。结果：288眼纳入观察，其中发生前房反应13例13眼，发生率为4.5%。其中，2例患者在术后第1d出现，11例发生在术后7d-14d。皆表现为不同程度的房水闪辉﹑色素播散，严重者出现人工晶状体前膜及虹膜后粘连。经散瞳﹑皮质类固醇以及全身应用抗生素药物治疗后，前房反应缓解，视力出现不同程度的提高，除1例因继发性青光眼施行抗青光眼小梁切除术后眼压控制外，其余未发现明显严重并发症。随访发现术后1a视力稳定在0.4以上者11眼(84.6％)。结论：糖尿病病人白内障术后前房炎症反应以迟发性为主，与特质性有关，应注重术后随访。充分术前准备；稳定血糖水平；选用生物相容性强的人工晶体；术后强化抗炎治疗等措施可降低前房反应的发生率并使其得到有效控制。
目的：探討糖尿病患者白內障術後前房反應的髮病特點及處理方法。方法：迴顧性分析併總結我院13例13眼糖尿病患者白內障超聲乳化聯閤人工晶狀體植入術後齣現前房反應的臨床資料﹑治療情況及隨訪結果。結果：288眼納入觀察，其中髮生前房反應13例13眼，髮生率為4.5%。其中，2例患者在術後第1d齣現，11例髮生在術後7d-14d。皆錶現為不同程度的房水閃輝﹑色素播散，嚴重者齣現人工晶狀體前膜及虹膜後粘連。經散瞳﹑皮質類固醇以及全身應用抗生素藥物治療後，前房反應緩解，視力齣現不同程度的提高，除1例因繼髮性青光眼施行抗青光眼小樑切除術後眼壓控製外，其餘未髮現明顯嚴重併髮癥。隨訪髮現術後1a視力穩定在0.4以上者11眼(84.6％)。結論：糖尿病病人白內障術後前房炎癥反應以遲髮性為主，與特質性有關，應註重術後隨訪。充分術前準備；穩定血糖水平；選用生物相容性彊的人工晶體；術後彊化抗炎治療等措施可降低前房反應的髮生率併使其得到有效控製。
목적：탐토당뇨병환자백내장술후전방반응적발병특점급처리방법。방법：회고성분석병총결아원13례13안당뇨병환자백내장초성유화연합인공정상체식입술후출현전방반응적림상자료﹑치료정황급수방결과。결과：288안납입관찰，기중발생전방반응13례13안，발생솔위4.5%。기중，2례환자재술후제1d출현，11례발생재술후7d-14d。개표현위불동정도적방수섬휘﹑색소파산，엄중자출현인공정상체전막급홍막후점련。경산동﹑피질류고순이급전신응용항생소약물치료후，전방반응완해，시력출현불동정도적제고，제1례인계발성청광안시행항청광안소량절제술후안압공제외，기여미발현명현엄중병발증。수방발현술후1a시력은정재0.4이상자11안(84.6％)。결론：당뇨병병인백내장술후전방염증반응이지발성위주，여특질성유관，응주중술후수방。충분술전준비；은정혈당수평；선용생물상용성강적인공정체；술후강화항염치료등조시가강저전방반응적발생솔병사기득도유효공제。
AIM: To study the mechanism and related factors of acute inflammation in anterior chamber after cataract surgery in diabetes. METHODS: 288 eyes were studied, 13 eyes (4.5%) with inflammation in anterior chamber after phacoemusification combined with intraocular lens (IOL) implantation were chosen for retrospective analysis and summary, with reference with fol ow up results. RESULTS: Significant inflammation in anterior chamber appeared on the first day after cataract surgery in 2 eyes, chronic inflammation in anterior chamber appeared on the 7-14 days after cataract surgery in 11 eyes. Inflammation in anterior chamber signed as different levels of anterior chamber flare and pigment diffusion. And some severe patients developed membrane before IOLs and posterior synechia in late period. With use of mydriatics, corticosteroid partial y and antibiotic agent after surgery, the inflammation in anterior chamber al eviated and visual acuity improved more or less, with no other serious complications. 11 patients' (84.6%) best corrected visual acuity(BCVA) were better steadily than 0.4 after one year .CONCLUSION: Inflammation in anterior chamber in diabetes after cataract surgery is mainly manifested as chronic inflammation and related to their special heterogeneity. Timely postoperative fol ow-up,good preoperative preparations is necessary for such patients, and with control and stabilization of blood sugar level, use of high biocompatibility IOLs ,active treatment may produce favourable surgery effect.
