梅毒螺旋体感染患者白内障手术效果观察  

Clinical effects of cataract surgery in patients with tremponema pallidum infection

作　　者：张蕾[1] 谭荣强[1] 周家承[1] 吴林彬[1] 郑春昌[1] 

机构地区：[1]肇庆市第一人民医院眼科,广东省肇庆市526020

出　　处：《眼科新进展》2014年第7期684-686,共3页Recent Advances in Ophthalmology

摘　　要：目的观察梅毒螺旋体感染白内障患者行小切口囊外摘出联合人工晶状体植入术的安全性及效果。方法对57例(57眼)梅毒螺旋体感染患者行小切口白内障囊外摘出联合人工晶状体植入术。术后观察视力、角膜、前房反应,并与同期一般老年性白内障患者63例(63眼)相比较。结果梅毒感染组术后1 d、3 d、1周最佳矫正视力≥0.4病例为15例、20例、52例,一般老年性白内障组术后1 d、3 d、1周最佳矫正视力≥0.4病例为56例、60例、62例,术后两组间视力比较,术后1 d、3 d差异均有统计学意义(均为P<0.05),术后1周两组间视力比较差异无统计学意义(P>0.05),但术后6个月和1 a时两组视力差异再次具有统计学意义(均为P<0.05);术后1 d、3 d、1周梅毒感染组Tyndall征阳性57例、28例、2例,前房纤维素性渗出20例、13例、0例,角膜水肿49例、15例、0例;一般老年性白内障组房水Tyndall征阳性为11例、1例、0例,前房纤维素性渗出为5例、0例、0例,角膜水肿为6例、4例、0例。两组间比较术后1 d、3 d Tyndall征阳性、前房纤维素性渗出、角膜水肿发生差异均有统计学意义(均为P<0.05),术后1周两组间比较差异无统计学意义(P>0.05)。两组术后后发性白内障发病率梅毒感染组高于一般老年性白内障组(P<0.05)。结论梅毒螺旋体感染白内障患者行小切口白内障囊外摘出联合人工晶状体植入术手术安全、有效,但需要早期积极控制葡萄膜炎并警惕神经梅毒存在。Objective To observe the security and efficacy of small incision ext- racapsalar cataract extraction and intraocular lens （IOL） implantation in patients with tremponema pallidum infection. Methods A total of 57 eyes of 57 patients with tremponema pallidum infection were retrospectively studied, and small incision extracapsalar cataract extraction and IOL implantation were performed. The postoperative visual acuity, corneal edema and anterior chamber inflanmlation were observed and compared with the homochronous surgery outcomes in 63 age-related cataract patients （53 eyes）. Results At postoperative 1 day, 3 days, 1 week, the best corrected visual acuity better than 0.4 in tremponema pallidum infection group were in 15 cases,20 cases,52 cases, respectively, which in age-related cataract group were in 55 cases ,60 cases, 62 cases, respectively. There were statistical differences at postoperative 1 day, 3 days, 6 months and 1 year between two groups （ all P 〈 0.05 ）, but the difference at postoperative 1 week was not statistically significant（P 〉 0.05 ）. At postoperative 1 day, 3 days, 1 Week, Tyndall （ ＋ ） in tremponema palli- dum infection group were in 57 cases,28 cases,2 cases ,respectively,which in age-related cataract group were in 11 cases,l cases, 0 case, respectively;The anterior chamber inflammation in tremponema pallidum infection group were in 57 cases, 28 cases, 2 cases, respectively, which in age-related cataract group were 5 cases, 0 case,0 cases, respectively; The corneal edema in tremponema pallidum infection group were in 49 cases, 15 cases,0 case,respectively,which in age-related cataract group were in 6 cases,4 cases,0 case. There were statistical differences in Tyndall（ ＋ ） ,anterior chamber inflammation and corneal edema at postoperative 1 day and 3 days between two groups （ all P 〈 0.05 ）, but no difference was found at postoperative 1 week（ all P 〉 0.05 ）. The incidence of posterior capsular opacification in tremponema pallidum infection group was h

关 键 词：梅毒螺旋体 梅毒 白内障 人工晶状体 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]