葡萄膜炎并发性白内障行超声乳化白内障吸除术后前房炎症反应的临床观察  

Clinical research of anterior chamber inflammation after phacoemulsification surgery in patients withcomplicated cataract secondary to uveitis

作　　者：陈婉[1] 林浩添[1] 吴昌睿[1] 谢楚芳[1] 黄祥坤[1] 陈伟蓉[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060

出　　处：《中华眼科杂志》2013年第3期212-216,共5页Chinese Journal of Ophthalmology

基　　金：广东省科技计划项目（20098080701017）

摘　　要：目的探讨超声乳化白内障吸除联合囊袋内人工晶状体（IOL）植入术对Vogt-小柳原田综合征和Behqet病并发性白内障患者前房炎症反应的影响。方法队列研究。纳入2010年1月至2011年6月间于中山大学中山眼科中心住院行超声乳化白内障吸除联合囊袋内IOL植入术的Vogt-小柳原田综合征和Behqet病并发性白内障患者17例（20只眼）作为实验组，所有患者炎症静止至少3个月；对照组选择同期行相同术式的年龄相关性白内障患者30例（40只眼）。应用激光蛋白细胞检测仪（LFCM）定量检测其手术前后的前房闪辉值及炎症细胞计数。两组患者年龄、超声乳化能量及时问的比较采用独立样本t检验；同组间手术前后房水闪辉值及炎症细胞计数的比较采用配对t检验；独立两样本间定量资料采用t检验。结果纳入研究的并发性白内障患者包括Vogt-小柳原田综合征9例（11只眼）、Behqet病8例（9只眼）。实验组在术前及术后各时间点所测的房水闪辉值分别是（19．86±6．47）、（44．28±18．47）、（35．60±12．65）、（23．85±8．41）和（13．86±4．27）pc／ms，均明显高于对照组（5．61±3．04）、（13．63±2．58）、（8．55±2．75）、（5．27±2．56）和（4．05±2．31）pc／ms，差异具有统计学意义（t术前=4．643，P术前〈0．01；t1d=6．035，P1d〈0．01；t7d=3．595，P7d=0．001；t30d=4．658，P30d〈0．01；t90d=3．308，Pgod=0．002）；实验组在术后第30天下降至术前水平（t=0．320，P=0．753），而对照组则在术后第7天时下降至术前水平（t=0．454，P=0．653）。实验组的房水炎症细胞计数在术后第1天、第7天时分别为（83．46±27．08）和（27．56±8．32）个／0．5mm^3，均高于术前（6．47±3．56）个／0.5mm^3（t1d=5．261，P1d〈0．01；t7d=2．766，P7d=0．012），第30天、术后第90天分别为（11．43±4．81）及（4．82±2．29�Objective To investigate anterior chamber inflammation after phacoemulsification with intraocular lens （IOL） implantation in patients with Vogt-Koyanagi-Harada （VKH） syndrome or Behcet＇s disease （BD）. Methods Cohort study. Seventeen patients （20 eyes） with complicated cataracts and VKH syndrome or BD who underwent phaeoemulsification with IOL implantation at Zhongshan Ophthalmic Center, Sun Yat-Sen University （SYSU） between January 2010 and June 2011 were included as the experimental group in this study. Cataract surgery was performed on these patients only when uveitis had been under control for more than three months. Thirty patients （40 eyes） with age-related cataracts who underwentphacoemulsification with IOL implantation in the same period were included as the control group. Quantitative measurements of anterior chamber aqueous flare and inflammatory cells were conducted preoperatively and postoperatively using a Laser Flare Cell Meter （LFCM）. Independent t-test was used to compare patients＇ ages, and the energy and time of phaeoemulsification between the two groups. The Student＇s t-test was used to assess the differences between paired data preoperatively and postoperatively. Independent t-test was also used to assess the quantitative data between groups. Results The study recruited 20 eyes in the experimental group and 40 eyes in the control group, including 11 eyes from 9 VKH patients and 9 eyes from 8 BD patients. The preoperative and postoperative flare values in the experimental group were （ 19. 86 ± 6. 47 ）, （44.28 ± 18.47 ） , （35.60 ± 12. 65 ）, （23.85 ± 8.41 ） , and （ 13.86 ± 4.27 ） pc/ms, respectively, which were statistically higher than that of the control group preoperatively, and on days 1,7,30, and90 after surgery （tpre =4.643, Ppre 〈0.01; t1 =6.035, P1 〈0.01; t7 =3.595, P7 = 0.001; t30 =4.658, P30 〈 0.01; t90 = 3. 308, P90 = 0.002）. Aqueous flare in Group A and Group B declined to preoperative levels on day 30 （t = 0. 320,

关 键 词：超声乳化白内障吸除术 葡萄膜脑膜脑炎综合征 贝赫切特综合征 前房 炎症 

分 类 号：R779.66[医药卫生—眼科]