葡萄膜炎并发白内障术后人工晶体前膜及后囊膜的激光治疗  

Treatment of anterior/posterior fibrous membrane of intraocular lens with Nd： YAG laser on uveitis patients

作　　者：刘小力 张美芬 

机构地区：[1]中国医学科学院、中国协和医科大学北京协和医院眼科,北京100730

出　　处：《中国实用眼科杂志》2008年第7期678-680,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨葡萄膜炎并发性白内障植入人工晶体（intraocular lenses IOL）术后，激光切除IOL前膜和混浊后囊膜的方法，并对疗效进行分析。方法对1999年9月至2007年2月行Nd：YAG激光（Coherent公司生产）切除IOL前膜及混浊后囊膜患者25例（38只眼），观察治疗的成功率，治疗后视力，术后并发症及影响机化膜再次形成的因素。结果38只眼（100％）均一次完全切除IOL前膜及混浊后囊膜，且IOL无损伤；32只眼（84.21％）治疗后视力提高。23只眼（60.53％）激光治疗1年后IOL前、后未再出现机化膜；15只眼（39．47％）治疗后因IOL前后再次形成机化膜而行两次以上激光治疗。3只眼（7.89％）术后眼压（〈21mmHg。激光能量大、激光治疗前有活动炎症、治疗后炎症反应重均与IOL前与后再次形成机化膜相关。结论应用Nd：YAG激光治疗葡萄膜炎并发白内障术后IOL前膜及后囊膜沿浊效果肯定，熟练掌握操作技巧是手术成功的关键。尽早去除IOL前膜及混浊后囊膜，术前控制炎症，术后加强抗炎治疗。可减缓IOL前与后机化膜的再次形成。Objective To assess the efficacy ofNd： YAG laser in removing the anterior/posterior fibrous membrane of intraocular lens （IOL） on uveitis patients. Methods Thirty-four eyes with the anterior/posterior fibrous membrane of IOL were treated by Nd： YAG laser from 1999-2007 in Peking Union Medical College Hospital. The efficacy was investigated from several aspects such as visual acuity, complications after the laser treatment and factors associated with the recurrence of fibrous membrane. Results Anterior/posterior fibrous membrane of IOL were successfully removed by Nd： YAG laser in all 38 eyes and IOLs were not damaged. The visual acuity was improved in 32 eyes （84.21%）. The fibrous membrane was not found in 23 （60.53%） eyes after the laser treatment. More than two times laser treatment was needed in 15 （39.47%） eyes because of recurrence of fibrous membrane prior/posterior to IOL. The intraocular pressure temporarily raised to above 21 mmHg in 3 （7.89%）eyes. Recurrence of the fibrous membrane was associated with high energy of laser, active uveitis before laser treatment and severe inflammatory reaction at anterior chamber after laser treatment. Conclusion Anterior/posterior fibrous membrane of IOL can be successfully removed by Nd： YAG laser on uveitis patients. The key point was the manipulating skill. Recurrence of the fibrous membrane could be prevented by removing the membrane earlier, better-controlled of Uveitis as well as aggressive medical therapy after the laser treatment.

关 键 词：激光 葡萄膜炎 人工晶体 纤维膜 

分 类 号：R776.1[医药卫生—眼科] R773.9[医药卫生—临床医学]