葡萄膜炎并发白内障小瞳孔下行超声乳化及人工晶状体植入术的疗效观察  

Clinical observations of phacoemulsification and IOL implantation for uveitis combined with cataract under microcoria

作　　者：高付林[1] 胡莲娜[1] 赵军[1] 麻南[1] 

机构地区：[1]解放军306医院眼科,北京市100101

出　　处：《眼科新进展》2009年第9期700-702,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨葡萄膜炎并发白内障在小瞳孔下行白内障超声乳化及人工晶状体植入术的手术方法及临床效果。方法对17例(30眼)葡萄膜炎并发性白内障、瞳孔直径2.0～4.0mm的患者,用显微虹膜拉钩扩大瞳孔,黏弹剂分离虹膜后粘连,完成白内障超声乳化及人工晶状体植入术,观察手术前后患者瞳孔、最佳矫正视力及并发症情况,并观察眼底情况。结果术中扩大瞳孔至4.0～6.0mm,手术顺利进行,术后第1天平均瞳孔直径为(3.70±0.31)mm,术后3个月、6个月瞳孔直径为(3.30±0.27)mm;术后6个月矫正视力≥0.5者24眼,0.3～0.4者3眼,0.1～0.2者2眼,小于0.1者1眼;术后黄斑水肿3眼,后发性白内障2眼,葡萄膜炎复发3眼。结论葡萄膜炎并发白内障在小瞳孔下行白内障超声乳化术,术中应用显微虹膜拉钩有利于扩大瞳孔,术后反应小,瞳孔近似圆形,可获得良好的矫正视力。Objective To investigate surgical methods and clinical results of phacoemulsification and IOL implantation for uveitis combined with cataract under microcoria. Methods The pupil were dilated by micro iris hooks, posterior synechia were separated by viscoelastic liquid, and phacoemulsification and IOL implantation were taken in 17 cases of uveitis combined with cataract patients （30 eyes）, with 2.0 mm to 4.0 mm pupil diameter. The pupil,best corrected visual acuity and complications were observed pre-and postoperatively. Changes of ocular fundus were observed. Results The pupil was dilated at 4.0 mm to 5.0 mm intraoperatively, and the surgery went smoothly. The average pupil diameter was （ 3.70 ± 0.31 ） mm at 1 day postoperatively, and （3.30 ±0.27 ） mm at both 3 months and 5 months postoperatively. The corrected visual acuity was and more than 0.5 in 24 eyes,0.3 to 0.4 in 3 eyes,0.1 to 0.2 in 2 eyes, and less than 0.1 in 1 eye at 6 months postoperatively. There were 3 eyes with macuiar edema,2 eyes with after-cataract, and 3 eyes recurred uveitis postoperatively. Conclusions In the process of phacoemuisification for uveitis combined with cataract under microcoria, micro iris hooks should be used to dilate the pupil, and the surgery is with minor response postoperatively, maintain round pupil and achieve well corrected vision.

关 键 词：葡萄膜炎 小瞳孔 白内障 超声乳化术 显微虹膜拉钩 

分 类 号：R776.1[医药卫生—眼科]