表面麻醉下白内障超声乳化人工晶状体植入治疗葡萄膜炎并发白内障

目的 :探讨葡萄膜炎并发白内障超声乳化摘除及人工晶状体植入术的疗效。方法 :对 3 8例 42只眼葡萄膜炎并发白内障患者行超声乳化摘除及人工晶状体植入术 ,其中 4只眼联合小梁切除术 ,3只眼联合周边虹膜切除术。结果 :术后 3 9只眼 (92 86% )视力较术前提高。术后 6个月裸眼视力≥ 0 5者 3 3只眼 (78 57% ) ,0 3～ 0 5者 3只眼 (7 14 % ) ,0 1～ 0 3者4只眼 (9 52 % ) ,<0 1者 2只眼 (4 76% )。结论 :超声乳化白内障摘除术治疗葡萄膜炎并发白内障 ,术后炎症反应轻 ,视力恢复好。     

人工晶状体植入术后的迟发性葡萄膜炎

目的探讨人工晶状体植入术后的迟发性葡萄膜炎的发病原因及预防方法。方法对不同类型的白内障囊外摘出联合人工晶状体植入术后所发生的迟发性葡萄膜炎11例(11眼)进行回顾性总结,分析其发病原因、发病时间、临床特点及预防方法。结果术后迟发性葡萄膜炎发生率为1.65%;自身免疫反应和术后抗生素、皮质类固醇用量不足是发病的主要原因;本病对皮质类固醇治疗敏感,只要及时治疗,一般预后良好。结论本病是由自身免疫变态反应引起的葡萄膜炎,术中尽量清理残余皮质,术后抗生素、皮质类固醇不可过早停药是降低本病的发生率的关键。     

葡萄膜炎并发白内障的人工晶体植入术

目的：探讨葡萄膜炎并发白内障的手术方式和疗效。方法：对27例31眼葡萄膜炎并发白内障行白内障摘除及人工晶体植入术,其中10眼联合玻璃体切除术及后囊切开术,2眼联合小梁切除术,4眼联合虹膜周切术。结果：术后28眼（90.32％）视力较术前提高。其中≥0.5者10眼,0.3－0.5者5眼,0.1－0.3者7眼,＜0.1者6眼。31眼术后眼压均控制正常。结论：葡萄膜炎并发白内障植人人工晶体可提高视力,对合并玻璃体混浊者联合玻璃体切除有助于术后视力提高。     

Chronic uveitis in Gaucher's disease

Thirty patients with Gaucher's disease have been examined in the authors' clinic; 29 of them suffered from the adult form and one had the juvenile type of the disease. The authors found intraocular abnormalities in four patients: three suffered from uveitis and in one, multiple vitreous opacities were observed. Two of the three patients had bilateral uveitis, while in one the uveitis was confined to the right eye only. In two of the three patients the manifestations of Gaucher's disease were present before the onset of uveitis. In one of the three, however, bilateral uveitis with spontaneous hyphema in the left eye was the presenting symptom. The diagnosis of Gaucher's disease in this case was arrived at during the work-up investigations for the etiology of the ocular manifestations. Initially the ocular symptoms in these three patients manifested as acute anterior uveitis, becoming chronic and involving also the posterior segments at a later stage.     

晶状体超声乳化人工晶状体植入治疗葡萄膜炎并发白内障

目的 探讨葡萄膜炎并发白内障晶状体超声乳化吸出及人工晶状体植入术的疗效.方法 对46例（52眼）葡萄膜炎并发白内障行晶状体超声乳化吸出及人工晶状体植入术,其中2眼联合小梁切除术.结果 术后48眼（92.31%）视力较术前提高.术后6月视力≥0.5者43眼（82.69%）,0.3～0.4者3眼（5.77%）,0.1～0.2者3眼（5.77%）,＜0.1者3眼（5.77%）.结论 晶状体超声乳化吸出术治疗葡萄膜炎并发白内障,术前充分准备,术中、术后处理得当,则术后炎症反应轻,视力恢复好.     

Paediatric uveitis: a Sydney clinic experience

PURPOSE: The aim of this study was to retrospectively review uveitis cases at The Children's Hospital at Westmead, Sydney, since its inception in 1997 to 2001, including patients presenting at the Camperdown, Sydney, campus between 1989 and 1997 attending Westmead for further care. Comparison is made with international centres. METHODS: Information was obtained from medical records. RESULTS: Forty patients (53 eyes) presented, of whom 23 (57.5%) were female and 17 (42.5%) were male (mean age 6.7 years). Of 53 eyes, 35 (66%) had anterior uveitis, three (5.7%) intermediate uveitis, seven (13.2%) posterior uveitis and eight (15.1%) panuveitis. Twenty-seven (67.5%) patients had disease unilaterally and 13 (32.5%) bilaterally. Twenty-four (60%) cases were idiopathic. Seven (17.5%) cases were associated with juvenile rheumatoid arthritis, three (7.5%) with herpes zoster, two (5%) with herpes simplex, two (5%) with toxocara, one (2.5%) with toxoplasma, and one (2.5%) with ulcerative colitis. Complications included cataract in 14 (26.4%) eyes; band keratopathy in four (7.5%) eyes; macular scarring in three (5.7%) eyes; and glaucoma in four (7.5%) eyes. Last measured acuity was 6/6 for 19 (35.8%) eyes, < or =6/18 for 15 (28.3%) eyes and <6/60 for eight (15.1%) eyes. CONCLUSIONS: Despite small numbers, the comparisons of this study with some international studies, and its contrasts with other studies, are due to similarities and differences amongst these studies with respect to factors of referral bias, and the aetiological basis of disease.     

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。     

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.     

Recent advances in Toll‐like receptors and anterior uveitis

Uveitis involves acute, recurrent or chronic inflammation of the uvea, and occurs when the normal state of ocular immune privilege has broken down. Accumulating evidence implicates the role of microbial triggers in the development of various forms of immune‐mediated uveitis in addition to its causative role in infectious uveitis. Toll‐like receptors (TLRs) are the most important pattern‐recognition receptors of the innate immune system that recognize pathogen‐associated molecular patterns of microbes. Activation of TLRs by pathogen‐associated molecular patterns leads to the induction of an inflammatory cascade and activation of both innate and adaptive arms of the immune response. TLRs have been implicated in the pathogenesis of various inflammatory diseases, including uveitis. This review provides an update on recent progress in TLR research and uveitis, specifically summarizing new evidence for the role of TLRs in anterior uveitis. There have been important observations from studies involving human ocular tissue, clinical uveitis and from experimental animal models of uveitis, such as endotoxin‐induced uveitis. The ‘Toll rush’ has certainly gained momentum, and future advances in this field have the potential for selectively targeting the TLR pathway and ultimately translating into better therapies for patients with sight‐threatening uveitis.     

药物源性葡萄膜炎

葡萄膜炎病因复杂,在非感染性葡萄膜炎中,药物源性是原因之一,特别是近年来新型药物剂型及给药方式的应用,越来越多的眼病与药物使用相关.根据Naronjo制定的药物源性疾病的诊断标准,已经发现有120余种药物与葡萄膜炎发病相关,常见的有利福布丁、西多福韦、磺胺、双碳膦酸盐类、抗TNFa抗体类以及治疗转移性肿瘤靶向性药物和多种疫苗等.     

葡萄膜炎并发白内障的人工晶状体植入术

目的探讨葡萄膜炎并发白内障的手术方式和疗效。方法对28例（28眼）葡萄膜炎并发白内障行白内障摘出及人工晶状体植人术，观察其视力变化及术中、术后并发症。结果术后26眼（92．86％）视力较术前提高。其中〉0．5者10眼，0．3。0．5者10眼，0．1。0．2者6眼，〈0．1者2眼。结论葡萄膜炎并发白内障植人人工晶状体。效果可靠。     

晶状体超声乳化联合人工晶状体植入术后迟发型葡萄膜炎临床分析

目的探讨晶状体超声乳化联合人工晶状体植入术后迟发型葡萄膜炎发病机制。方法回顾性分析18例19眼老年性白内障行晶状体超声乳化联合人工晶状体植入术后迟发型葡萄膜炎的发病、表现、治疗及治疗结果。结果晶状体超声乳化联合人工晶状体植入术后迟发型葡萄膜炎高发期为术后2-8周,发生率为7.85%,均表现为急性前葡萄膜炎症状,部分病例于过度劳累后及皮质类固醇类眼药过早停药或突然停药后发病。局部及全身皮质类固醇治疗效果明显,预后良好。结论晶状体超声乳化联合人工晶状体植入术后迟发型葡萄膜炎发病机制可能为晶状体皮质残留、人工晶状体材料所含可溶性化学物质及人工晶状体本身引起的免疫反应等多因素所致。过度劳累、过早或突然停用含激素类眼药可为其诱发因素。     

葡萄膜炎并发白内障两种手术方法的探讨

目的 介绍2种小瞳孔下行葡萄膜炎并发性白摧障摘出和瞳孔成形的手术方法。方法 30例34只葡萄膜炎严重后粘连并发性白内障的眼接受了该2种手术,手术方法：91）剪除瞳孔区机化的前囊膜,瞳孔缘剪开,水分离核,囊袋内晶关於 本圈匙反转娩出晶状体体核。人工晶状体（IOL）植入;（2）上方虹膜根部切除,分离并剪开上方虹膜,超声乳化白内障摘出,IOL植入,最后缝合上方虹膜,人造圆形瞳孔。结果 术后34眼瞳孔均在3.0-3.5mm,并保持圆形,均无后囊膜破裂,无严重并发症发生,视力均比术前有不同程度的提高。结论 葡萄膜炎并发白内障。在采用所介绍的2种手术方法后能获得良好的视力和圆形瞳孔,而无严重并发症。     

葡萄膜炎诊断中正确应用眼内液检测

眼内液检测是指采用房水或玻璃体样本进行的实验室检查，可用于某些类型葡萄膜炎的诊断。本文概述了眼内液检测的具体内容和检查结果的解读，阐述了其在葡萄膜炎诊断中的适应证，并对目前此类检查中存在的误区及其带来的后果进行了剖析。绝大多数葡萄膜炎患者可根据病史、临床检查及辅助检查即可做出诊断，并不需要进行眼内液检测，仅在少数特定的炎症如眼内炎、肿瘤所致的伪装综合征、眼弓形虫病、眼弓蛔虫病等才需进行眼内液检测。过度依赖眼内液检测查找病因不仅增加了感染的风险，对多数葡萄膜炎的病因诊断帮助不大甚至误诊误治。     

聚合酶链反应在感染性葡萄膜炎诊断中的应用

聚合酶链反应（polymerase chain reaction,PCR）是一种有力的分子生物学工具,检测所需标本量少,耗时短,敏感性高,对于某些不典型的感染性葡萄膜炎,PCR能够在感染早期从极少量眼内液中检测出病原体的复制数量,提高诊断的效率。与传统的血清学抗体检测、病原微生物培养相比,PCR在辅助诊断方面表现出更大的优势。     

肿瘤坏死因子拮抗剂在葡萄膜炎治疗中的应用

肿瘤坏死因子能激活其他的细胞因子,诱导一氧化氮合酶,上调黏附分子,增加细胞介导的免疫和肉芽肿形成,而肿瘤坏死因子拮抗剂可以抑制辅助性T细胞,从而进一步抑制浸润性巨噬细胞活化,保护葡萄膜炎中的组织不受破坏,已用于葡萄膜炎的治疗并取得了较好的治疗效果。本文就肿瘤坏死因子拮抗剂在葡萄膜炎治疗中的应用进行综述。     

葡萄膜炎并发白内障超声乳化人工晶状体植入

目的探讨葡萄膜炎并发白内障超声乳化吸出及人工晶状体植入术的效果。方法26例（26眼）均于炎症稳定3月以后进行透明角膜切口晶状体乳化吸出术，植入后房人工晶状体。术中慎重处理小瞳孔和虹膜后粘连，尽量避免刺激虹膜。结果26眼中有2眼轻度炎症反应，术后1月裸眼视力≥0．5者20眼（76．92％），0．3～0．4者4眼（15．38％）．〈0．05者2眼（7．69％）。结论超声乳化白内障吸出人工晶状体植入术治疗葡萄膜炎并发白内障，选好手术时机，术中慎重操作，则术后炎症反应轻，视力恢复好。