葡萄膜炎并发性白内障瞳孔粘连的手术治疗

目的:探讨葡萄膜炎并发白内障虹膜后粘连小瞳孔状态下手术技巧、时机及疗效。方法:对45例56眼葡萄膜炎并发性白内障小瞳孔患者,在葡萄膜炎控制稳定,炎症消退3个月后,借助粘弹剂分离虹膜后粘连或施行瞳孔环型扩张,再行白内障超声乳化或囊外摘出及人工晶体植入。结果:术后48眼(85%)视力较术前提高,其中≥0.5者19眼,0.3～0.5者13眼,0.1～0.3者16眼。瞳孔圆形或椭圆形。术后眼压均控制在正常范围。结论:葡萄膜炎并发性白内障虹膜后粘连,可使瞳孔扩大成圆形或椭圆型,有利于实施白内障超声乳化或囊外摘除,且瞳孔括约肌不受损伤,避免术后眩光,可获得良好视力,术中、术后并发症减少。

Surgery for uveitis complicated cataract eye adhesion

Objective:To investigate the surgical mangement and effects in uveitis complicatecd cataract with a small synechia pupil.Methods 56eyes of45cases of cataract with small pupil,separating the posterior synechia with the help of viscoelastics or papillary collar resection of iris had firstly been performed,and then phacoemulsification and IOL implantation was done.Results:Visual acuity was improved in48eyes(85%).19eyes gained postoperative visual acuity had0.5or better,13eyes had0.3～0.5,16eyes had0.1～ 0.3.There was no postoperative intraocular hyper-tension. Conclusion:This technique could open up small pupil to a certain degree and was advantageous to the perfor-mance of phacoemulsification and IOL implantation without sphincter injury.Vision after operation has increased with few complications.