葡萄膜炎并发性白内障手术的研究进展  

Surgical management of complicated cataract in uveitis

作　　者：陆宛 陆惠 朱思泉 LU Wan;LU Hui;ZHU Si-quan(Belting Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《国际眼科纵览》2018年第4期265-269,共5页International Review of Ophthalmology

摘　　要：葡萄膜炎并发白内障的发生机制与炎症反复发作及长期使用糖皮质激素相关。白内障摘除联合人工晶状体植入是其主要的治疗手段。在炎症未控制时行手术治疗，存在术后炎症反应重、并发症多等现象。手术时机应为炎症静止至少3个月后，围手术期联合局部或全身应用糖皮质激素术后效果更为理想。为避免糖皮质激素的全身副作用、增加眼部药物浓度，部分专家选择术中前房内给药或植入缓释剂。炎症反复发作所致的广泛虹膜粘连、瞳孔闭锁为手术实施带来较大困难，对术者有较高的要求。另外，选择合适的人工晶状体可降低术后炎性反应及后发性白内障的发生率。Cataract is one of the common complications of uveitis, which may be associated with recurrent episodes of inflammation and long-term use of glucocorticoids. Cataract extraction with intraocular lens implantation has become the main treatment. Patients with activity inflammation have a serious postoper- ative inflammatory reaction and complications. It is generally believed that the operation time should be three months after the inflammation resolution at least. Local or systemic treatment with glucocorticoids is more effective over perioperative. For avoiding systemic side effects of glucocorticoids and increasing the concentra- tion in eyes, some experts choose to inject drugs or implant the sustained release agent in anterior chamber. The extensive iris adhesion and pupillary atresia caused by the recurrent inflammation makes the operation much more difficult, which is a challenge for surgeon. In addition, the appropriate intraocular lens can reduce postoperative inflammatory reactions and the incidence of subsequent cataracts.

关 键 词：葡萄膜炎 白内障/并发性 手术治疗 

分 类 号：R779.66[医药卫生—眼科]