葡萄膜炎-青光眼-前房积血综合征的临床特征分析

目的 回顾分析葡萄膜炎-青光眼-前房积血(UGH)综合征的临床特征。设计回顾性病例系列。研究对象2018-2022年山东中医药大学附属眼科医院UGH患者8例(8眼)。方法回顾患者的病历资料,总结其临床表现、治疗方法及预后。主要指标临床表现及影像学检查结果。结果所有8例患者均为IOL植入术后1～6个月出现本病临床表现。平均眼压(42.91±11.54)mmHg,均存在不同程度的前房闪辉,前房积血4例,房水涂片存在红细胞4例。IOL偏位并与虹膜及睫状体接触,2例因虹膜后凹致IOL与虹膜后表面接触,4例IOL偏位与虹膜后表面接触,1例与睫状体接触。1例采用药物治疗,2例虹膜后凹的患者采用YAG激光虹膜切开,IOL调位术、IOL置换术、IOL取出术、青光眼阀植入术、睫状体光凝术各1例。治疗后随访6～46个月,前房闪辉及房水红细胞消失,IOL与虹膜及睫状体接触消失。结论UGH综合征的临床特征表现为白内障术后IOL与虹膜睫状体接触、眼压升高、前房闪辉、房水存在红细胞。其治疗以解除IOL与周围组织的摩擦为根本措施。(眼科,2023,32:127-132)

Clinical characteristics of uveitis glaucoma hyphema syndrome

Objective To analyze the clinical features of uveitis-glaucoma-hyphema (UGH) syndrome. Design Retrospective case series. Participants 8 patients (8 eyes) diagnosed with UGH syndrome in the Eye Hospital affiliated to Shandong University of Traditional Chinese Medicine from 2018 to 2022. Methods The clinical data of 8 patients with UGH syndrome were reviewed and the clinical characteristics, treatment and prognosis were sumarized. Main Outcome Measures Clinical characteristics and imaging findings. Results 8 UGH syndrome patients were attack from 1 to 6 months after IOL implantation. The average IOP was (42.91±11.54) mmHg, and there were different degrees of anterior chamber flare in all patients, 4 cases had hyphema and 4 cases had red blood cells on the aqueous smear. All cases had IOL deviation and contaction with iris and ciliary body. 2 cases of posterior concave of iris demenstrate IOL contactiont with posterior surface of iris. 4 cases exist IOL deviation and contact with posterior surface of iris. 1 case exists contact with ciliary body. One case was treated with drugs, two cases with posterior fovea of iris were treated with YAG laser iridotomy. One case each was treated with IOL repositioning, IOL replacement, IOL removal, glaucoma valve implantation, and ciliary body photocoagulation. All patients were followed up for 6 to 46 months after treatment. The anterior chamber flare and red blood cells in the anterior chamber disappeared, and the IOL contacting with the iris and ciliary body disappeared. Conclusion The clinical features of UGH syndrome are IOL contacting with iris or ciliary body after cataract surgery, high IOP, anterior chamber flare and red blood cells existing in the anterior chamber. Its treatment is to relieve the friction between IOL and iris or ciliary body. (Ophthalmol CHN, 2023, 32: 127-132)