虹膜炎并发白内障瞳孔粘连手术治疗的临床观察
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Clinical observation of surgical treatment of iritis complicated with cataract pupil adhesion
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    摘要:

    目的:探讨手术治疗虹膜炎并发白内障瞳孔粘连的有效方法。方法:虹膜炎并发白内障瞳孔粘连21例27眼,经复方托吡卡胺滴眼液散瞳瞳孔直径<4mm者。视力光感~0.2,光定位不确定者1眼,角膜陈旧性KP(+)15眼,房水闪辉(-),瞳孔广泛性后粘连3眼,瞳孔膜闭2眼,虹膜膨隆高眼压2眼。分离粘连虹膜,镊撕除瞳区或瞳孔缘机化膜后,以纤维虹膜拉钩扩大瞳孔,常规进行的白内障超声乳化手术,观察术后反应及视力。结果:术后1mo视力,25眼视力均较术前提高(93%),其中0.5~者16眼(59%), 0.3~者5眼(19%), 0.1~者3眼(11%),<0.1者2眼,无变化者1眼(合并视神经萎缩)。术后瞳孔近生理圆形20眼(74%),不规则7眼(26%)。瞳孔直径>7mm者6眼(22%),2眼诉眩光(7%)。结论:超声乳化配合显微虹膜拉钩扩瞳措施可以顺利完成虹膜炎并发白内障瞳孔粘连手术,术后患者视力明显提高,视觉质量得到明显改善,是一种有效的治疗方法。

    Abstract:

    AIM:To explore the effective surgical treatment of iritis complicated with cataract pupil adhesion.METHODS:Totally 21 cases(27 eyes) with iritis complicated with cataract and pupil adhesion were collected, all pupil diameter <4mm after tropicamide eye drops dilating the pupil. There were visual acuity of light perception to 0.2 and optical positioning uncertainty 1 case (1 eye), corneal old KP (+) 15 eyes, aqueous flare (-), pupil extensive posterior adhesions 3 eyes, occlusion of pupil 2 eyes and iris bombe high intraocular pressure 2 eyes. After separating the adhesions iris, tweezers tearing the pupil area or edge of the pupil machine membrane, fiber iris retractors dilated the pupils and conventional phacoemulsification were carried out. The postoperative reaction and visual acuity were observed.RESULTS:Visual acuity of postoperative 1 month, 25 eyes all improved compared with preoperation (93%), better than 0.5 in 16 eyes(59%), 0.3 to 0.5 in 5 eyes(19%), 0.1 to 0.3 in 3 eyes(11%), worse than 0.1 in 2 eyes, no change in 1 eye(complicated with optic nerve atrophy). Postoperative pupil was almost physiological round in 20 eyes (74%), irregular in 7 eyes (26%). There were 6 eyes (22%) pupil diameter> 7mm, 2 eyes(7%) of glare.CONCLUSION: Phacoemulsification combined with microscopic iris retractors dilating pupil can successfully completed iritis complicated with cataract pupil adhesion. Postoperative visual acuity and visual function significantly improve. It is an effective treatment. 

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冯督,张清生.虹膜炎并发白内障瞳孔粘连手术治疗的临床观察.国际眼科杂志, 2012,12(9):1758-1759.

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  • 收稿日期:2012-05-18
  • 最后修改日期:2012-08-06
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