人工晶状体植入术后并发眼前节毒性综合征
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Complication of toxic anterior segment syndrome after IOL implantation
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    摘要:

    目的:通过分析眼前节毒性反应综合征(toxic anterior segment syndrome, TASS)患者的临床表现, 寻找TASS的患者的发病原因、治疗方法及预后。

    方法:通过前房及玻璃体穿刺培养的方法排除感染性细菌性眼内炎,考虑为TASS患者6例7眼,局部应用抗生素和糖皮质激素眼液及玻璃体腔注射万古霉素1mg及头孢他啶2mg治疗,观察治疗后效果。

    结果:所有TASS患者前房液及玻璃体液培养均未见细菌生长。TASS患者1例2眼经局部类固醇激素眼液治疗,5例5眼经前房冲洗、玻璃体腔注药后,前房炎症明显好转,视力提高,随访6mo,未再出现眼部异常表现。查找致病因素时根据排除法考虑为消毒锅的原因,及时清洗和更换滤网后发生率明显降低。

    结论:尽管TASS是眼前段手术的罕见并发症,及时查找致病原因,早期正确诊断及积极有效的治疗预后良好。

    Abstract:

    AIM: To evaluate the treatment process of toxic anterior segment syndrome(TASS)and to found out the effective treatment, aetiological agent and prognosis.

    METHODS: A total of 6 cases(7 eyes)were suspected with TASS by clinical situations. Bacterial infectious endophthalmitis could be ruled out by anterior chamber and vitreous body paracentesis. All patients were treated with local application of antibiotics and glucocorticoid eyedrops, and some patients were treated with intravitreal injection of 1mg vancomycin and 2mg ceftazidime. The therapeutic effects after treatment were observed.

    RESULTS: There were no bacterial growth in 6 cases(7 eyes)with TASS by anterior chamber fluid and vitreous humor culture. After administrated with antibiotics and glucocorticoid eye drops, inflammation was steady in 1 case(2 eyes). After anterior chamber irrigation and intravitreal medicine injection, anterior chamber inflammation were improved significantly in 5 cases(5 eyes). No ocular abnormality was seen in following up 6mo. Risk factors was considered as the cause of sterilization pot, the incidence decreased obviously by timely cleaning change and filter.

    CONCLUSION: TASS is a rare complication of ocular anterior segment surgery. Good prognostic results will be achieved with correct analysis, criterion and effective treatment.

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郭娟.人工晶状体植入术后并发眼前节毒性综合征.国际眼科杂志, 2014,14(9):1683-1685.

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  • 收稿日期:2014-03-19
  • 最后修改日期:2014-08-04
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  • 在线发布日期: 2014-08-19
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