色素膜炎并发白内障的手术治疗体会.docVIP

色素膜炎并发白内障的手术治疗体会 　　[摘要] 目的 探讨并总结色素膜炎并发白内障超声乳化手术过程中的各步技巧、小瞳孔的处理方式及手术的临床效果。 方法 收集2014年3～9月于西安市第四医院治疗的45例色素膜炎并发性白内障患者的临床资料，所有患者均为小瞳孔，并存在不同程度的瞳孔后粘连，患者均行超声乳化手术及人工晶体植入术。术中采取多种方式扩大瞳孔，达到手术需要。术后观察并分析患者视力恢复及眼部并发症等情况。 结果 所有患者都顺利完成手术，术后视力有不同程度的提高。术后瞳孔形态均为圆形或近圆形。术后发生角膜水肿2例，眼压升高11例，前房炎症渗出3例，经相应治疗均恢复正常。 结论 色素膜炎并发性白内障手术中，采取有效的措施扩大瞳孔，谨慎操作，可使手术更加安全有效。 　　[关键词] 色素膜炎；并发性白内障；小瞳孔；超声乳化术 　　[中图分类号] R779.6 [文献标识码] A [文章编号] 1673-7210（2015）07（c）-0089-04 　　[Abstract] Objective To investigate and summarize the techniques， treating microcoria and clinical effects of ultrasonic emulsification operation for uveitis with cataract. Methods The clinical data of 45 patients with uveitis with catarac treated in the Fourth Hospital of Xian City from March 2014 to September 2014 were selected， and all patients were given ultrasonic emulsification operation and intraocular lens implantation， all patients were microcoria and had different degrees of iris posterior synechiae. Various ways were used to expand the pupil after operation， in order to achieve the surgery need. Conditions of vision recovery and eye complications after operation were observed and analyzed. Results All patients finished the operation smoothly， and their vision improved after operation， pupils shape were round or suborbicular. There were 2 cases of corneal edema， 11 cases of elevated intraocular pressure， 3 cases of anterior chamber inflammation effusion， all of them returned to normal after symptomatic treatment. Conclusion In the surgical treatment for cataract induced by uveitis， adopting effective measures to expand the pupil and prudent operation can make surgery more safe and effective. 　　[Key words] Uveitis； Complicated cataract； Microcoria； Ultrasonic emulsification operation 　　色素膜炎患者随着病情发展，常常出现并发性白内障，造成视力严重下降，影响正常生活，需行白内障手术治疗[1-4]。但色素膜炎性反应，引起瞳孔变形、粘连、晶状体悬韧带不健康等，均使手术难度增加，并影响术后视功能改善[5-8]。现将西安市第四医院（以下简称“我院”）手术治疗的色素膜炎并发白内障患者手术操作及术后效果进行归纳总结，现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　选择2014年3～9月在我院手术治疗的色素膜炎并发性白内障患者45例（52眼），其中男21例，女2