儿童双眼葡萄膜炎并发白内障的处理

13岁女性，因“双眼视力下降4年，不伴红痛”人院。双眼矫正视力：右眼眼前手动，左眼0．1。裂隙灯检金：双眼角膜带状变性，KP（-），虹膜后粘连，右眼晶状体混浊，表面色素附着，左眼晶状体表面色素纤维膜覆盖，双眼内窥不清。指测眼压：双眼T＋1。患儿曾诊断为葡萄膜炎、白内障。两年前左眼白内障摘除并植入人丁晶状体，期间末正规治疗葡萄膜炎，现为行右眼白内障手术入院。讨论体会：儿童女性患者双眼前葡萄膜炎应考虑幼年型类风湿关竹炎／幼年型特发性关节炎（JRA／JIA）的可能，早期控制原发病、合理治疗并发症是改善视力预后的关键。

Management of complicated cataract in children with bilateral uveitis

A 13-year-ohl girl was admitted for a 4-year history of poor vision in both eyes without redness or pain. Best-corn＇ected visual acuity： VOD was hand move befiwe eye and VOS was 2/20. Slit-lamp examination revealed corneal band-shaped degeneration, KP（-）, posterior synechiae of iris in hoth eyes. In the right eye, lens was cloudy with pigment in the anterior capsule, and in the left eye, the pupil was covered by a fibrous membrane. The fundus of both eyes was n~t seen. Both of the intraocular pressure were T ＋ 1 by digital measuring. The girl was once diaguosed elsewhere as ＂uveitis and cataract＂ , and received cataract surgery and intraocular lens implantation in her left eye 2 years ago. During the following 2 years, she was never regularly treated for the uveitis. This time, she came to our hospital for treating the cataract of the right eye. When seeing a female child with OU anterior uveitis, diagnosis of juvenile rheumatoid arthritis/juvenile idiopathic arthi＇itis shouhl be highly suspeeted. The keys for the visual pruguosis are early treatment on uveitis and appropriate treatment on complications.