人工晶状体植入后迟发性葡萄膜炎的治疗

目的　观察和探讨人工晶状体植入术后迟发性葡萄膜炎的治疗。方法　对 17例 ( 17眼 )白内障人工晶状体植入术后迟发性葡萄膜炎进行观察 ,均在术后 2周左右发生急性炎症反应 ,采用散瞳及地塞米松、庆大霉素联合 5 氟尿嘧啶结膜下注射进行治疗。结果　除 1例人工晶状体瞳孔夹持 ,视力较差外 ,其它病例均于 5～ 10天内炎症消退 ,视力恢复。结论　迟发性葡萄膜炎是人工晶状体植入术后出现较晚的术后并发症 ,及早治疗 ,效果良好     

人工晶状体植入术后迟发性葡萄膜炎及t-PA治疗

目的 探讨白内障摘出人工晶状体植入术后迟发性葡萄膜炎的发病机制和tPA治疗效果。方法 回顾性分析12眼人工晶状体植入术后迟发性葡萄膜炎的临床资料。结果 人工晶状体植入术后迟发性葡萄膜炎的发生率为3．29％，经过t-PA 10μg前房内注射，5～10天前房内纤维蛋白完全吸收，视力恢复良好，无后遗症。随访9～12月，无1眼复发，视力稳定。结论 白内障摘出人工晶状体植入术后迟发性葡萄膜炎是由免疫复合物介导的急性葡萄膜炎症反应，前房内注射t-PA治疗白内障摘出人工晶状体植入术后迟发性葡萄膜炎是一种简单安全可靠的方法。     

人工晶状体植人后迟发性葡萄膜炎的治疗

目的 观察和探讨人工晶状体植入术后迟发性葡萄膜炎的治疗。方法 对17例(17眼)白内障人工晶状体植入术后迟发性葡萄膜炎进行观察，均在术后2周左右发生急性炎症反应，采用散瞳及地塞米松、庆大霉素联合5-氟尿嘧啶结膜下注射进行治疗。结果 除1例人工晶状体瞳孔夹持，视力较差外，其它病例均于5～10天内炎症消退，视力恢复。结论 迟发性葡萄膜炎是人工晶状体植入术后出现较晚的术后并发症，及早治疗，效果良好。     

人工晶状体植入术后迟发性葡萄膜炎14例分析

目的：探讨白内障囊外摘除后房型人工晶体状植入术后迟发性葡萄膜炎的发病机制、诱因及防治。方法：对14例人工晶状体植入术后迟发性葡萄膜炎患者的发病时间、诱因、眼部表现及治疗结果等临床资料进行总结分析。结果：人工晶状体植入术后迟发性葡萄炎的发病率为3.1%。发病时间最早在术后第二周，最迟在术后1年。糖尿病及风湿病患者的发病率较高。术后用药不规则及局部过早停药、早期过度用眼、过度疲劳可诱发本病。全部病体经局部及全身应用激素治疗后，炎症在一周内完全消退，视力恢复。结论：人工晶状体植入术后迟发性葡萄膜炎是一种由免疫复合物介导的葡萄膜炎症反应，正确治疗，预后良好。随着术后时间的推移，其发病率会逐渐降低。术后定期复查及规则用药，炎症消退后局部常规用药1个月，避免早期过度用眼及过度疲劳可降低本病的发病率。     

人工晶状体植入术后迟发性葡萄膜炎38例分析

目的探讨人工晶状体植入术后迟发性葡萄膜炎的发病机制及影响因素。方法总结分析1027例，人工晶状体植入术后迟发性葡萄膜炎38例（38眼）临床资料。结果本组术后迟发性葡萄膜炎的发生率为3．70％，其发病因素与术后过早停药、糖尿病、眼部术前并发症等有关，本病对皮质类固醇治疗敏感，及时治疗，预后良好。结论人工晶状体植入术后迟发性葡萄膜炎是免疫复合物介导的急性葡萄膜炎，术前严格掌握手术适应症，术中尽量清除干净晶体皮质，术后不过早停药，并注意控制糖尿病人的血糖水平，应可降低其发生率。     

白内障超声乳化吸除联合人工晶状体植入术后迟发性葡萄膜炎治疗分析

目的 探讨白内障超声乳化吸除联合人工晶状体植入术后迟发性葡萄膜炎的病因和治疗方法。方法 对白内障超声乳化吸除联合人工晶状体植入术后48例(50只眼)迟发性葡萄膜炎患者进行回顾性总结，分析其发病时间、临床特点及治疗方法。结果 50只眼术前均无葡萄膜炎病史。术后早期(1周)眼内反应性炎症消失后，出现急性葡萄膜炎症反应。(1)发病时间最早在术后10天，最迟在术后5月，平均27天。(2)临床表现各异：眼痛、视力下降或无任何自觉症状。人工晶状体前膜可2天内出现。(3)37只眼经局部及全身皮质类固醇治疗，炎症消失；11只眼人工晶状体前膜用YAG激光治疗；1只眼经局部及全身皮质类固醇治疗仍反复发生葡萄膜炎，手术取出人工晶状体后再未复发；1只眼经局部及全身皮质类固醇治疗仍反复发生葡萄膜炎，眼球轻度萎缩。结论 白内障超声乳化吸除联合人工晶状体植入术后迟发性葡萄膜炎可能是由免疫复合物介导的变态反应引起。术后定期复查、早期诊断、及时应用皮质类固醇可减少并发症发生。YAG激光治疗人工晶状体前膜是积极有效的方法。     

白内障人工晶状体植入术后迟发性葡萄膜炎

目的探讨白内障人工晶状体植入术后迟发性葡萄膜炎的发病机制和治疗方法。方法本组白内障术后迟发性葡萄膜炎10例12眼，年龄45～79岁，平均67岁。全部行白内障囊外摘出联合后房型人工晶状体植入术，术后早期（5～10d）眼内葡萄膜炎反应基本消失后，突然发生急性葡萄膜炎反应，发病时间为术后13～37d．平均18.75d。全部患者局部及全身应用皮质类固醇、消炎痛及散瞳剂治疗。结果眼部炎症10d左右基本消失。除1眼视力下降外，其余视力均达反应前水平，无严重并发症。随访3～6个月，平均4.5个月，无1例复发。结论白内障术后迟发性葡萄膜炎是由免疫复合物介导的急性前葡萄膜炎症反应，用皮质类固醇及早治疗可预防严重并发症，恢复良好视力。     

人工晶状体术后迟发性葡萄膜炎(附3例报告)

白内障人工晶状体植入术后常发生不同程度的术后炎症反应,多数经治疗后在1周内逐渐消退和消失。但也有在炎症消退后一段时间后突然出现急性葡萄膜炎发生。治疗及时则预后良好,若治疗不及时,可出现视力丧失及眼球萎缩等严重并发症。我院在1996年6月～2000年12月间发现3例白内障人工晶状体植入术后迟发性葡萄膜炎。现总结如下:     

人工晶状体植入术后迟发性葡萄膜炎的治疗观察

目的探讨人工晶状体植入术后迟发性葡萄膜炎的治疗及病因。方法回顾性分析38例(43眼)人工晶状体植入术后迟发性葡萄膜炎的发病原因,进行了散瞳、结膜下及球周注射地塞米松、妥布霉素、玻璃酸酶等综合治疗。结果自身免疫反应和术后擅自停药、劳累为发病主要原因。本组患者经3～7 d治疗,视力恢复良好。结论本病可能是免疫复合物介导的急性葡萄膜炎症,及时正确处理可获得较好的视力。早期避免局部停药、劳累可降低其发生率。     

白内障摘出人工晶状体植入术后迟发性葡萄膜炎

目的 探讨手法小切口白内障囊外摘出人工晶状体植入术术后迟发性葡萄膜炎的临床特点、治疗方法和预防措施。方法 回顾分析226例（239眼）手法小切口白内障囊外摘出人工晶状体植入术的11例（11眼）发生迟发性葡萄膜炎的临床资料。结果手法小切口白内障囊外摘出人工晶状体植入术术后迟发性葡萄膜炎的发生率为4．60％,多数发生于术后2～3周。应用散瞳剂,糖皮质激素,非甾体消炎药等进行治疗,3～10d前房炎症完全控制,视力恢复良好,1例人工晶状体瞳孔夹持。结论迟发性葡萄膜炎是手法小切口白内障囊外摘出人工晶状体植入术术后出现较晚的并发症,对术后恢复良好的视力又造成严重损害,及早诊断和治疗效果良好。     

白内障人工晶体植入术后迟发型急性前葡萄膜炎

目的 :探讨白内障术后迟发型急性前葡萄膜炎发生的病因及治疗方法。方法 :对 11例白内障囊外摘除联合后房型人工晶体植入术后迟发型急性前葡萄膜炎患者的发病时间、诱因、临床表现、皮质残留情况及治疗进行回顾性分析。结果 :发病时间一般发生在术后 3周左右 ;女性患者发病率明显低于男性 (P <0 0 5 ) ;以有糖尿病或关节炎的白内障患者、外伤性白内障或第二次施行白内随手术患者的发生率较高 ;散瞳检查 ,周边皮质残留检出率较高 ;对皮质类固醇治疗敏感。结论 :白内障术后迟发型急性前葡萄膜炎可能是由免疫复合物介导的变态反应引起 ,用皮质类固醇及早治疗可预防严重并发症的发生     

兔眼后房型人工晶状体植入术后循环免疫复合物动态观察

目的 研究后房型人工晶状体植入术后循环免疫复合物(CIC)的变化及人工晶状体对CIC的影响。方法 大耳白兔40只,随机分为A、B两组,每组20只;A组行右眼透明晶状体超声乳化吸出联合人工晶状体植入;B组行右眼透明晶状体超声乳化吸出。分别在术前及术后第7、14、21、28和35d采血,用聚乙二醇比浊法测定CIC。结果 A、B两组术后CIC均升高,于术后第21d达最高峰,35d降至术前水平,两组间差异无显著性(t=0.37 P>0.05)。结论兔眼后房型人工晶状体植入术后,CIC升高持续4～5周,人工晶状体植入与术后CIC变化无明显相关性。     

人工晶状体植入术后迟发性葡萄膜炎的治疗

目的探讨人工晶状体植入术后迟发性葡萄膜炎的治疗方法.方法对26例(28眼)人工晶状体植入术2周后发生葡萄膜炎及人工晶状体前膜形成,进行散瞳,结膜下注射地塞米松和尿激酶等综合治疗.结果本组患者经3～7天治疗,效果良好,视力由治疗前0.1～0.5,恢复至0.2～1.2.仅有2眼因虹膜后粘连及人工晶状体瞳孔夹持,视力恢复不理想(0.2).结论迟发性葡萄膜炎是人工晶状体术后出现较晚的眼内免疫性反应,如能早期治疗均可获得良好效果.     

后房型人工晶体植入术后迟发性葡萄膜炎

目的：探讨白内障摘除后房型人工晶体植入术后迟发性葡萄膜炎的发病机制。方法；对白内障超声乳化吸除后房型人工晶体植入术后12例13眼迟发性葡萄膜炎患者资料进行回顾性总结分析。本组老年性白内障患者，男4例5眼，女8例8眼，平均年龄62岁（43-72岁）。常规完成白内障超声乳化吸除后房型人工晶体植入，在术后早期（7-10天）眼内炎症完全消失或基本消失的情况下，突然发生急性葡萄膜炎症反应，发病时间最早在术后第12天，最迟34天，平均17.93天。结果：经局部及全身皮质类固醇、消炎痛治疗，6-15天眼部炎症完全消失，视力恢复良好，无严重并发症与后遗症，随访6-24个月，平均18.6个月，无一例复发，视力稳定。结论：后房型人工晶体植入术后迟发性葡萄膜炎是由免疫复合物介导的急性葡萄膜炎症反应，及时正确处理，可获得较好的效果随着手术后时间的推移。免疫复合物逐渐清除及人工晶体在眼内耐受，其发病率会逐渐降低。     

Extracapsular cataract extraction and posterior chamber intraocular lens implantation in uveitis patients.

PURPOSE: Intraocular lens implantation in uveitis patients has been a controversial issue. The purpose of this study is to evaluate the visual and surgical outcomes of extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens (PC IOL) implantation in a diverse group of uveitis patients. PATIENTS AND METHODS: The results of 39 cases of ECCE and PC IOL implantation in 30 patients with uveitis were retrospectively analyzed. Five patients (six eyes) had pars plana vitrectomies combined with ECCE and PC IOL implantation. Patient age ranged from 26 to 71 years (average, 53.0 years). Specific uveitic syndromes were determined for 22 patients (73.3%). The postoperative follow-up period ranged from 6 to 43 months (average, 20.3 months). RESULTS: Visual acuity improved postoperatively in 38 eyes (97.4%), and this improvement ranged from 1 to 11 Snellen lines (average, 7.5 Snellen lines). Visual acuity improved postoperatively to 20/40 or better in 32 eyes (82%). Seven eyes had visual acuity worse than 20/40, which was attributed to posterior segment abnormalities after ECCE and PC IOL implantation. Uveitis recurred in 20 eyes (51.3%), and postoperative cystoid macular edema (CME) was observed in 18 eyes (46.2%). In all cases, the recurrent uveitis and CME improved or resolved with corticosteroid therapy. CONCLUSION: These results suggest selected uveitis patients can have improved vision without unacceptable risk for 1 to 3 years after ECCE and PC IOL implantation.     

白内障超声乳化治疗葡萄膜炎并发白内障临床分析

目的：探讨白内障超声乳化治疗葡萄膜炎并发白内障的临床效果。方法：对20例20眼葡萄膜炎并发白内障患者行白内障超声乳化摘除及人工晶状体植入术,其中3眼联合周边虹膜切除术。结果：术后2wk18眼（90%）视力较前提高。术后2wk矫正视力〉0.5者10眼（50%）,0.3～0.5者5眼（25%）,0.1～0.2者2眼（10%）,〈0.1者1眼（5%）,视力无变化者2眼（10%）。结论：超声乳化治疗葡萄膜炎并发白内障,虽然手术较复杂,但整体效果良好。     

Investigation of the safety of an intraocular lens with reversibly adjustable optical power: the *Acri.Tec AR-1 PC/IOL

PURPOSE: To report the safety of a newly developed intraocular lens (PC/IOL) with reversibly adjustable refractive power (*Acri.Tec AR-1 PC/IOL) after implantation into adult human eyes. The surgical setup and specially designed instruments required for implantation will be evaluated. The examined parameters included: stability of the IOL during implantation, positioning of the IOL, rotation of the IOL, integrity of the posterior lens capsule, central visual acuity, morphology of the eye, clinical signs of inflammation, intraocular pressure, refraction. METHODS: The study was carried out on 35 human eyes after using the Acri.Tec AR-1 PC/IOL after lens removal through phacoemulsification; as control, the implantation of conventional PC/IOL into the second eye of 29 patients was used. The mean follow-up was 9 + 6 months. An initial adjustment surgery of the *Acri.Tec AR-1 PC/IOL was carried out 2 weeks after implantation in 2 patients; the follow-up of these eyes was 3 and 6 months. RESULTS: Implantation was possible without any problem. Eyes healed normally. No difference between eyes containing the *Acri.Tec AR-1 PC/IOL and eyes containing conventional PC/IOLs could be detected with respect to visual acuity, stabilization of refractive error, signs of inflammatory reaction, slitlamp microscopic aspect of the eye and intraocular pressure. As intended, initial adjustment surgery successfully changed the mydriatic refraction from +1.0 resp. +0.75 dpt to 0 resp. -0.5 dpt. 26 bilaterally pseudophakic patients including 2 patients having had adjustment surgery had more than 3 months follow-up. Mean visual acuity in the AR-1 PC/IOL group at 3 months (0.76 +/-0.24) did not differ from mean visual acuity in the pseudophakic control group (0.74 +/-0.23). Adjusted eyes had a visual acuity of 1.0. No adverse effects occurred. CONCLUSION: Initial data suggest that the *Acri.Tec AR-1 PC/IOL can be safely implanted into the capsular bag of adult human eyes and can beadjusted after implantation, thereby achieving the desired change of refraction. Further exploration of the potential usefulness of this type of reversibly adjustable PC/IOL as a tool for refractive optimization is warranted.     

Further investigation of the tolerance and mechanical adjustability of the *Acri.Tec AR-1 PC/IOL in rabbit eyes: an intraocular lens with reversibly adjustable optical power

PURPOSE: To examine the tolerance and mechanical function of an adjustable intraocular lens (IOL) in rabbit eyes. METHODS: Implantation of the *Acri.Tec AR-1 PC/IOL into 14 rabbit eyes. Manipulation of the lens 8 weeks after implantation in order to change the refractive power. Follow-up for up to 5 months. Histopathologic examination of the eyes. RESULTS: Implantation and mechanical adjustment of the PC/IOL were possible. Eyes healed normally. No difference between eyes containing the *Acri.Tec AR-1 PC/IOL and eyes containing the control PC/IOL could be detected with respect to signs of inflammatory reaction, corneal transparency, intraocular pressure and histopathologic appearance. Histopathologic examination of the eyes showed that the *Acri.Tec AR-1 PC/IOL did not cause any damage in rabbit eyes. CONCLUSION: The *Acri.Tec AR-1 PC/IOL is well tolerated in rabbit eyes for extended periods of time, suggesting that this PC/IOL should be well tolerated in the long run. Surgical adjustment of the adjusting element can be performed with little effort several weeks after implantation.