曲安奈德在外伤性白内障手术中的应用

目的 观察曲安奈德在外伤性白内障手术中的作用.方法 对32例32眼外伤性白内障行白内障摘出术.晶状体后囊完整的10例10眼行常规小切口白内障囊外摘出术,人工晶状体植入囊袋后向前房内注入曲安奈德;伴有后囊破裂玻璃体脱入前房的22例22眼行白内障摘出联合前段玻璃体切割术,术中前房内注入曲安奈德,完全清除前房内的玻璃体皮质.术后观察角膜情况、前房内炎症反应、眼压变化、黄斑水肿情况、视力预后等.结果 32例患者术后仅有2例因角膜破口较大且不规则而发生角膜水肿,3例患者发生后囊混浊.所有患者前房清亮,无炎症反应,无不可耐受的眼压升高,检眼镜下未见明显的黄斑水肿.结论 外伤性白内障术中使用曲安奈德,可以提高手术的可视性和安全性,抑制术后炎症反应,减少近期及远期并发症,视力预后较好.

Application of triamcinolone in traumatic cataract

Objective Traumatic cataract is very common in young people and children.After the traumatic cataract surgery,the inflammatory reaction is always very serious,especially in children.We used triamcinolone in the operation of cataract extraction to help to stain and remove the vitreous body which punch into the anterior chamber after the operation.This paper was to observe the effect and complication of triamcinolone in traumatic cataract surgery.MethodsThirty-two cases with traumatic cataract were divided into two groups.Ten eyes of 10 cases with the intact posterior lens capsules were in group 1,and 22 eyes of 22 cases with disruptive posterior lens capsules and vitreous cortex exodus into the anterior chamber were in group 2.The extracapsular cataract extraction(ECCE)and intraocular lens(IOL)implantation were performed on all the cases in group 1.During the operation,triamcinolone were injected into the anterior chamber and then were flushed with BBS until sporadic triamcinolone particles were seen on the iris after the IOL were implanted.Pars plana lentectomy and anterior vitrectomy were performed on the cases of group 2.In these eyes,triamcinolone were injected into the anterior chamber,and the vitreous cortex in the anterior chamber was removed completely.The cornea,IOP,macular,visual acuity and complication were observed after the operation.ResultsCornea edema was seen in 2 cases,and cornea edema in 1 case disappeared in the 3rd day after the operation.In the 7th day after the operation,all cornea became transparent.Capsule opacification was found in 2 cases in the 7th day after the operation,and 3 had capsule opacification in the 14th day after the operation.No other complications happened.The visual acuity change was as follows:0.3 in 1 case(1 eye),0.3-0.5 in 4 cases(4 eyes),0.5-0.8 in 12 cases(12eyes)and 0.8-1.0 in 15 eyes of 15 cases.ConclusionThe application of triamcinolone could improve visibility and safety in traumatic cataract surgeries,restrain inflammatory reaction after operation,reduce operation complication and improve the visual acuity.