超声乳化人工晶状体置入术治疗肾移植术后白内障的疗效观察

 目的 观察超声乳化联合人工晶状体置入术治疗肾移植术后白内障的效果。方法 采用回顾性病例对照研究。肾移植术后白内障患者(观察组)23例30只眼,以及同期就诊的单纯年龄相关性白内障患者(对照组)26例33只眼,两组患者性别、年龄匹配,均行超声乳化联合人工晶状体植入手术。全部患者术前、术后进行眼科检查包括矫正视力、眼压测定、裂隙灯检查、间接检眼镜眼底检查及光学相干断层成像(OCT)。术前检测角膜内皮细胞计数。术后4周检查泪膜破裂时间(BUT),并行干眼主观症状评分。结果 肾移植术后患者行白内障手术者占2.3%,其中后囊下白内障(PSC)多见,发生率为65.2%。观察组患者术前眼压高于对照组(P=0.017),术后视力检查显示观察组患者治疗后1周、4周时的矫正视力与对照组无统计学差异(P＞0.05),两组手术并发症发生率无统计学差异(P＞0.05)。但观察组术后泪膜破裂时间(BUT)明显短于对照组(P=0.000),术后干眼主观症状的评分明显高于对照组(P= 0.002)。结论 肾移植术后白内障患者,行超声乳化及人工晶状体置入术治疗安全有效,术后视力恢复良好,但术后干眼症状较重。

Effect of phacoemulsification and intraocular lens implantation in patients after renal transplantation

Objective To observe the visual outcome and complications of phacoemulsification and intraocular lens implantation in cataract patients after renal transplantation.Methods A retrospective study was conducted. Twenty-three cataract patients (30 eyes) after renal transplantation (observation group) and 26 patients with age-related cataract (control group) were included in this study. The two groups, which were matched in age and gender, underwent phacoemulsification and intraocular lens implantation. Before and after cataract surgery, the best corrected visual acuity and intraocular pressure were determined, while slit lamp examination, fundus examination with indirect ophthalmoscopy and optical coherence tomography were performed.Corneal endothelium cell density was evaluated before surgery. Tear film break-up time (BUT) and the subjective score for dryness were calculated 4 weeks after surgery.Results The rate of cataract surgery after renal transplantation was 2.3%,and posterior subcapsular cataract was the more common type (65.2%)among these patients. The preoperative intraocular pressure of the observation group was higher than that of the control group(P=0.017). There was no statistically significant difference in the visual acuity one week and four weeks after operation between the two groups (P>0.05), or in surgical complications (P>0.05). Postoperative tear film break-up time of the observation group was significantly shorter than that of the control group (P=0.000), while subjective score for dryness in the observation group was significant higher than that of the control group (P=0.002).Conclusions Phacoemulsification and intraocular lens implantation are safe and effective for cataract patients after renal transplantation, and the visual acuity can recover after surgery, but the symptoms of dry eye are serious after surgery.