曲安奈德前房注射在前葡萄膜炎并发白内障手术中的疗效观察

目的观察曲安奈德(TA)前房注射在前葡萄膜炎并发白内障手术中的有效性及安全性。方法葡萄膜炎并发白内障患者34例(38只眼),均由同一医师进行手术。所有患者随机分为对照组(19只眼)和实验组(19只眼)。实验组所有患者均行透明角膜切口白内障超声乳化吸除联合人工晶状体植入术,术毕前房内注入TA1mg;对照组术式同实验组,术毕未行TA注入。观察术后7 d患者视力情况;术后1、3、7 d患者前房炎症反应情况;术后1、7、14 d及1个月时眼压情况;术后1、4及8周角膜内皮计数。结果术后1、3、7 d实验组前房炎症反应明显低于对照组,差异有统计学意义,术后各时间点两组患者眼压及角膜内皮计数均在正常范围,差异无统计学意义。结论 TA前房注射在前葡萄膜炎并发白内障手术中可有效控制前房炎症反应,无明显不良反应。     

葡萄膜炎并发白内障术后前房注射地塞米松的疗效观察

目的:探索白内障摘除术后前房注射0.1mL地塞米松对葡萄膜炎并发白内障患者术后的影响。方法:试验组术后前房注射0.1mL地塞米松,对照组前房未注射地塞米松,观察两组术后炎症反应。结果:术后前2d两组患者视力间差别有统计学意义(P<0.05),术后第1d角膜水肿程度两组间有统计学差异(P<0.05),前房闪辉差异有统计学意义(P<0.05),且试验组术后患者视力提高者百分比高于对照组。结论:葡萄膜炎并发白内障患者行白内障超声乳化+人工晶状体植入术,术毕前房注射0.1mL地塞米松者可减轻短期术后炎症反应,可更早提高患者视力,对患者术后短期眼压未见明显影响。     

葡萄膜炎并发白内障的手术治疗探讨

长期葡萄膜炎并发白内障的发生率为50%～70%.其术后炎症反应明显高于老年性白内障术后.为探讨葡萄膜炎并发白内障更有效的手术方式,现将我们在1999年10月"视觉第一中国行动"中施行的18例葡萄膜炎并发白内障手术,总结如下.     

曲安奈德对年龄相关性白内障术后前葡萄膜炎的疗效及其对炎症因子的影响

目的　观察曲安奈德对年龄相关性白内障术后前葡萄膜炎的临床疗效及其对相关炎症因子的影响。方法　选择２０１０年２月至２０１２年６月间我科收治的年龄相关性白内障患者１６８例（１６８眼）为研究对象,按照治疗方式的不同分为对照组和曲安奈德组,每组各８４例（８４眼）。对照组予以术后结膜下注射地塞米松,而曲安奈德组给予前房注射２ｍｇ曲安奈德,对比两组患者术后第１天、第３天和第５天的最佳矫正视力、眼压、前房细胞数、房水闪辉情况,并于术后第５天测肿瘤坏死因子-α（ｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒ-α,ＴＮＦ-α）、干扰素-γ（ｉｎｔｅｒｆｅｒｏｎ-γ,ＩＦＮ-γ）和白细胞介素-１０（ｉｎｔｅｒｌｅｕｋｉｎ-１０,ＩＬ-１０）的含量变化。结果　曲安奈德组患者的最佳矫正视力在术后第３天已有明显改善,显著优于对照组（Ｐ＜０．０５）。且两组间前房细胞数及房水闪辉比较发现,术后第３天和第５天,两组差异均具有统计学意义（均为Ｐ＜０．０５）。术后第５天曲安奈德组的ＴＮＦ-α和ＩＦＮ-γ的表达水平分别为（１９．６±８．９）ｐｇ?Ｌ－１、（１４．４±７．８）ｐｇ?Ｌ－１,显著低于对照组（２９．５±１４．２）ｐｇ?Ｌ－１、（３９．８±１０．３）ｐｇ?Ｌ－１,差异均有统计学意义（均为Ｐ＜０．０５）,而ＩＬ-１０含量两组间比较差异却无统计学意义（Ｐ＞０．０５）。结论　年龄相关性白内障手术中前房注射曲安奈德可有效抑制术后前葡萄膜炎,减少前房反应,且抗炎效果良好。     

并发性白内障术中前房注射曲安奈德的临床研究

目的探讨前房注射曲安奈德对前葡萄膜炎并发性白内障人工晶状体植入术后前房渗出的预防效果及安全性。方法将68例（68眼）前葡萄膜炎并发性白内障行白内障摘出人工晶状体植入术的患者随机分为两组：实验组34例,术中前房内注射曲安奈德2mg（0.05ml）;对照组34例,术中未注射曲安奈德。观察并比较两组术后前房渗出情况及角膜内皮细胞密度、眼压等指标。结果实验组术后前房渗出明显低于对照组,差异有统计学意义（P〈0.05）;曲安奈德对角膜内皮及眼压无明显影响。结论前房注射曲安奈德可减轻前葡萄膜炎并发性白内障人工晶体植入术后前房渗出,是一种安全有效的给药方法。     

葡萄膜炎并发白内障的手术疗效

葡萄膜炎是常见的严重的致盲性眼病，葡萄膜炎并发白内障是白内障手术的难点之一。我们于2001年1月～2003年6月共收治葡萄膜炎并发白内障56例60只眼，同期随机分为2组，分别行超声乳化白内障摘除术(Phaco)和现代囊外摘除术(ECCE)联合人工晶状体植入手术，现将结果报告如下。     

超声乳化术治疗葡萄膜炎并发白内障

我们于 1999年 3月～ 2 0 0 3年 3月对 36眼葡萄膜炎并发白内障患者采用超声乳化 +人工晶状体植入进行治疗 ,现报告如下。1　资料与方法1.1　一般资料　葡萄膜炎并发白内障患者 33例 36眼 ,男 16眼 ,女 2 0眼 ,年龄 19～ 71岁 ,葡萄膜炎发病 8个月～ 30a,前葡萄膜炎 2 5眼 ,全葡萄膜炎 10眼 ,中间葡萄膜炎 1眼。1.2　术前检查　 (1)视力 :光感 18眼 ,手动 15眼 ,指数 3眼 ,光定位色觉均正常 ;(2 )瞳孔膜闭 3眼 ,闭锁 4眼 ,除 2眼外其余均有不同程度虹膜后粘连 ;(3)角膜KP(- ) 2 1眼 ,色素性KP(+) 10眼 ,羊脂状KP(+) 5眼 ;(4)白内障核硬度…     

葡萄膜炎并发白内障的处理

葡萄膜炎通常并发白内障，白内障发生的原因可以是葡萄膜炎本身也可是治疗葡萄膜炎的药物如皮质类固醇所致，对这类患的处理一直有争议，特别是关于人工晶体的植入。最近有报道继发于葡萄膜炎的白内障，用超声乳化技术，囊袋内植入后房型人工晶体，联合或不联合玻璃体切割术治疗获得成功，重要的问题是，术前患眼应消除炎症，术前术后应加强抗炎治疗，通过正确的处理，葡萄膜炎患可以通过白内障出联合人工晶体的植入术，使其视     

超声乳化术治疗葡萄膜炎并发白内障的疗效观察

目的 :评价超声乳化术 人工晶体植入治疗葡萄膜炎并发白内障的临床疗效。方法 :2 1例葡萄膜炎并发白内障的患者接受超声乳化术 人工晶体植入 ,观察其视力变化及术中、术后并发症。结果 :90 5 %眼术后视力均有不同程度的提高 ,最佳矫正视力≥ 0 3者 17眼 ,约占 81% ;其中最佳矫正视力≥ 0 5者 12眼 ,占5 7 14 %。两眼术后视力无提高 ,其中一眼为陈旧性黄斑病变 ,另一眼为视神经萎缩 ;术中、术后无严重并发症。结论 :超声乳化术联合人工晶体植入是治疗葡萄膜炎并发性白内障的一种好方法。     

葡萄膜炎并发白内障手术治疗的临床观察

目的　探讨葡萄膜炎并发白内障手术治疗的方法和临床效果。方法　３３例（３３眼）葡萄膜炎并发白内障患者行超声乳化人工晶状体植入术治疗,术前和术后给予泼尼松联合环磷酰胺治疗。术后观察视力、眼压、并发症以及葡萄膜炎复发等情况。术后随访６个月。结果　３３眼术后视力均有不同程度提高。术后最佳矫正视力≤０．１者３眼（９．０９％）,＞０．１～＜０．５者１１眼（３３．３３％）,０．５～＜１．０者１４眼（４２．４２％）,≥１．０者５眼（１５．１５％）。术后并发症包括后发性白内障２眼（６．０６％）,虹膜轻微后粘连６眼（１８．１８％）,白细胞数量轻度降低１例（３．０３％）。术后眼压均控制在正常范围内。随访期内未见葡萄膜炎复发。结论　葡萄膜炎并发白内障行白内障超声乳化人工晶状体植入术,术前和术后给予小剂量糖皮质激素联合环磷酰胺治疗效果较好,便于临床应用。     

葡萄膜炎并发白内障的手术治疗

目的:探讨葡萄膜炎并发白内障施行超声乳化吸除人工晶状体植入治疗的临床效果。方法:对19例21眼稳定的葡萄膜炎并发白内障患者行超声乳化吸除晶状体植入术,术中根据虹膜粘连的程度和范围,分别采用不同的方法处理粘连虹膜及小瞳孔。结果:患者19例21眼术后19眼视力改善,总有效率90%,其中术后视力≥0.3者15眼(71%)。术后无严重并发症发生,无葡萄膜炎加重。结论:超声乳化吸除人工晶状体植入术是治疗葡萄膜炎并发白内障的有效方法。术前控制炎症稳定3mo,术中掌握处理虹膜粘连及小瞳孔的要点,慎重操作,可减少术后并发症,改善患者视功能。     

白内障超声乳化治疗葡萄膜炎并发白内障临床分析

目的：探讨白内障超声乳化治疗葡萄膜炎并发白内障的临床效果。方法：对20例20眼葡萄膜炎并发白内障患者行白内障超声乳化摘除及人工晶状体植入术,其中3眼联合周边虹膜切除术。结果：术后2wk18眼（90%）视力较前提高。术后2wk矫正视力〉0.5者10眼（50%）,0.3～0.5者5眼（25%）,0.1～0.2者2眼（10%）,〈0.1者1眼（5%）,视力无变化者2眼（10%）。结论：超声乳化治疗葡萄膜炎并发白内障,虽然手术较复杂,但整体效果良好。     

超声乳化吸除治疗葡萄膜炎并发白内障的研究

目的：探讨施行超声乳化吸除人工晶状体植入治疗葡萄膜炎并发白内障的疗效。方法：回顾分析32例38眼葡萄膜炎并发白内障患者超声乳化手术治疗前后的情况。手术中先用黏弹剂钝性分离,瞳孔不能扩大者,用囊内剪沿瞳孔缘做环形剪除,做连续环形撕囊,囊袋内植入人工晶状体,观察手术并发症和术后视力,观察时间为术后6mo。结果：术后1mo有33眼（87%）视力较术前提高,其中〉0.5者22眼,0.3～0.5者6眼,0.1～0.25者7眼,〈0.1者3眼,术后瞳孔接近圆形。部分瞳孔恢复对光反应,无严重并发症发生。结论：本手术方法对葡萄膜炎并发白内障有良好的疗效,手术损伤小。     

超声乳化联合前段玻璃体切割治疗葡萄膜炎并发性白内障

目的: 探讨白内障超声乳化联合前段玻璃体切割治疗葡萄膜炎并发白内障的临床疗效。方法: 选取我院2010-03/2012-10葡萄膜炎并发白内障患者20例24眼进行观察,均行白内障超声乳化联合前段玻璃体切割术治疗,术中均植入人工晶状体。结果: 术后随防6～12mo,23眼(96%)视力得到不同程度提高,6眼(25%)术中虹膜出血,2眼(8%)术后前房炎症反应,1眼(4%)出现一过性眼压升高。结论: 超声乳化联合前段玻璃体切割是目前治疗葡萄膜炎并发性白内障较为有效的方法,可有助于控制炎症反应,提高视功能,减少并发症。     

超声乳化人工晶状体植入治疗葡萄膜炎并发性白内障

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1 d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。     

前葡萄膜炎并发白内障22例手术体会

目的　探讨前葡萄膜炎并发白内障的手术时机。治疗的效果 ,观察术后炎症反应。方法　待炎症稳定后即行手术 ,手术前后均以普南扑灵滴眼液滴眼 ,口服消炎痛。常规超声乳化 人工晶状体植入。结果　观察 3月到 1年 ,与单纯性年龄相关性白内障手术效果相同 ;前葡萄膜炎均未复发。结论　前葡萄膜炎并发白内障炎症稳定后即行手术治疗是安全的。     

Manual small-incision cataract surgery under topical anesthesia for post-uveitis complicated cataract

Purpose:Cataract development is a common sequelae associated with uveitis. Despite phacoemulsification being the popular method of cataract surgery today, manual small-incision cataract surgery (MSICS) may still be a safe and effective alternative because of several inherent benefits. There is not much literature and studies on the efficacy and safety of MSICS under topical anesthesia in complicated cataract in patients with uveitis. We aimed to study the safety and visual outcome of MSICS under topical anesthesia for post uveitis complicated cataract.Methods:This was a retrospective observational study. The electronic medical records of adult patients who underwent MSICS under topical anesthesia for post uveitis cataract were reviewed. The records were reviewed and analyzed for preoperative clinical characteristics and visual acuity, intraoperative complications and postoperative visual acuity, and complications.Results:A total of 71 eyes of 59 patients were taken for final analysis. The average age of patients was 59.9 years. There was improvement in the best corrected visual acuity by 0.7 logMAR (P value <0.0001). Average follow-up period was 9.8 months. The mean gain in visual acuity in eyes that received preoperative steroids was 0.6 logMAR compared to the eyes that did not receive steroids (0.71 logMAR). The difference was not statistically significant (P = 0.407). Complications seen during long-term follow-up were recurrence (15.5%), cystoid macular edema (7%), Epiretinal membrane (8.5%), and posterior capsular opacification (5.5%).Conclusion:With proper technique and precautions, MSICS can be safely and comfortably performed under topical anesthesia even in complicated cataracts with excellent visual and safety outcomes.     

Surgical outcomes of complicated cataract with pediatric trematode granulomatous uveitis

AIM: To describe the clinical characteristics and surgical outcomes of complicated cataract with pediatric trematodal granulomatous uveitis (TGU).METHODS: Patients of cataract with TGU in the membranous (inactive) stage underwent cataract surgery with intraocular lens (IOL) implantation. Preoperative history and ophthalmic examination were conducted for all cases, whereas Schimphlug imaging and corneal topography were done for some patients. Postoperative follow up was done on the 1st, 2nd, and 5th postoperative days after surgery. Then, it was done at least at one, three, and six months postoperatively. Intraoperative and postoperative complications and the methods of their management were reported.RESULTS: Twelve eyes of 12 male children were included in this study ranging from 8 to 16y. The mean best corrected Snellen visual acuity (BCVA) was significantly improved from 0.09±0.06 preoperatively to 0.37±0.11 at the final visit 6mo postoperatively (P<0.001). Schimphlug imaging and corneal topography showed flattening of the anterior surface of the inferior cornea. Intraoperative difficulties and complications included the poor dilatability of the drown down pupil, strong posterior synechia between the anterior lens capsule and the iris at the site of the inferior retrocorneal vascularized membrane and hyphema. All cases underwent primary hydrophobic IOL implantation.CONCLUSION: Surgery for this type of cataract is relatively safe and effective. It is associated with some specific difficulties and complications that should be considered during surgery and follow up.     

A combined anterior and posterior approach to cataract surgery in patients with chronic uveitis

Although several recent papers have focused on the results of cataract surgery in patients with uveitis, little has been published on specific surgical techniques that are most appropriate to such cases. We have found that a combined anterior and posterior approach using extracapsular techniques (usually phacoemulsification) and pars plana vitrectomy, with or without intraocular lens placement, is best suited for selected uveitis patients who have cataract, vitreous opacities, and cystoid macula edema. This paper discusses the surgical techniques that we have found to be best for the management of these cases.Supported in part by Core Grant EYO 3040 from the National Eye Institute/NIH, Bethesda, Maryland, and by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York.