Inomata Hajime, Yoshikawa Hiroshi, Rao Narsing A
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 7-15-703 Kuromon, Chuo-ku, Fukuoka 810-0055, Japan.
Ophthalmology. 2003 Oct;110(10):1942-5. doi: 10.1016/S0161-6420(03)00658-4.
To describe the occurrence of phacoanaphylaxis in enucleated eyes of patients with Behçet's disease.
Retrospective, observational, case series and human tissue study.
Twenty-six patients with Behçet's disease who underwent enucleation.
Histopathologic analysis was performed on 28 enucleated eyes of 26 patients with Behçet's disease. The eyes were divided into two groups, based on the absence or presence of tractional retinal detachment associated with cyclitic membrane formation. Selected eyes with tractional retinal detachment were stained for immunohistochemical examination.
Histopathologic examination of enucleated eyes, including routine histopathologic and immunohistochemical studies.
None of the five eyes without retinal detachment showed phacoanaphylaxis. Nine of the 23 eyes with detachment exhibited phacoanaphylaxis, 10 showed no inflammation of the lens, and four were aphakic. There was marked inflammatory cell infiltration in the cyclitic membrane of all nine eyes with phacoanaphylaxis. Immunohistochemical examination demonstrated positive staining for the macrophage markers in the epithelioid and giant cells. The average interval between onset of the ocular manifestations of Behçet's disease and enucleation was 63 months for eyes with phacoanaphylaxis and 35 months for eyes without phacoanaphylaxis (P<0.005).
In Behçet's disease, eyes with long-standing intraocular inflammation complicated by cyclitic membrane formation may develop phacoanaphylaxis. Such patients may benefit from surgical removal of the cyclitic membrane along with the lens in eyes with significant visual function.
描述白塞病患者眼球摘除术后发生晶状体过敏性眼内炎的情况。
回顾性、观察性病例系列及人体组织研究。
26例行眼球摘除术的白塞病患者。
对26例白塞病患者的28只摘除眼球进行组织病理学分析。根据是否存在与睫状体膜形成相关的牵引性视网膜脱离将眼球分为两组。选择有牵引性视网膜脱离的眼球进行免疫组织化学染色检查。
摘除眼球的组织病理学检查，包括常规组织病理学和免疫组织化学研究。
5只无视网膜脱离的眼球均未发生晶状体过敏性眼内炎。23只发生视网膜脱离的眼球中，9只出现晶状体过敏性眼内炎，10只晶状体无炎症，4只为无晶状体眼。所有9只发生晶状体过敏性眼内炎的眼球的睫状体膜均有明显的炎性细胞浸润。免疫组织化学检查显示上皮样细胞和巨细胞中的巨噬细胞标志物呈阳性染色。发生晶状体过敏性眼内炎的眼球从白塞病眼部表现出现到眼球摘除的平均间隔时间为63个月，未发生晶状体过敏性眼内炎的眼球为35个月（P<0.005）。
在白塞病中，长期存在眼内炎症并伴有睫状体膜形成的眼球可能发生晶状体过敏性眼内炎。对于视功能显著受损的此类患者，手术切除睫状体膜及晶状体可能有益。
