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[葡萄膜炎-青光眼-前房积血综合征的特征与处理]

[Characteristics and management of Uveitis-Glaucoma-Hyphema syndrome].

作者信息

Duchêne M, Iscar C, Muraine M, Gueudry J

机构信息

Service d'ophtalmologie-centre hospitalo-universitaire Charles-Nicolle, 22, boulevard Gambetta, 76031 Rouen, France.

Service d'ophtalmologie-centre hospitalo-universitaire Charles-Nicolle, 22, boulevard Gambetta, 76031 Rouen, France.

出版信息

J Fr Ophtalmol. 2020 Mar;43(3):205-210. doi: 10.1016/j.jfo.2019.07.030. Epub 2020 Jan 22.

Abstract

INTRODUCTION

Uveitis-Glaucoma-Hyphema syndrome (UGH) is caused by mechanical chafing of anterior segment structures by an intraocular lens, especially an anterior chamber lens. The objective of this study was to characterise the clinical course and risk factors of UGH syndrome at a time when posterior chamber implantation is the gold standard.

PATIENTS AND METHODS

This was a retrospective study of 30 cases of UGH syndrome managed between January 2014 and September 2018. Data from the initial clinical examination, the type of implant involved and the clinical management were analysed.

RESULTS

Thirty eyes of 28 patients were included. Intra ocular lenses were iris-sutured (15/30, 50 %), in the bag (6/30, 20 %), scleral-fixated (4/30, 13.3 %), in the ciliary sulcus (3/30,10 %) or "in and out" (2/30, 6.7 %). Initial management was medical (18 eyes) or surgical (12 eyes). Surgical procedures were explantation (n=4), IOL repositioning (n=7) or trabeculectomy (n=1). Recurrences occurred with medical treatment (9/18), but not in the surgical group (p=0.02). Ocular hypertension became chronic in 19 cases out of 30 (63.3 %).

CONCLUSION

UGH syndrome can be caused by any type of pseudophakic lens. An intraocular lens in the bag should not rule out the diagnosis. Despite the decreasing popularity of anterior chamber intraocular lens implantation, UGH syndrome remains a current condition and must be recognised in order to adapt therapeutic management.

摘要

引言

葡萄膜炎-青光眼-前房积血综合征(UGH)是由人工晶状体,尤其是前房型人工晶状体对眼前节结构的机械摩擦所致。本研究的目的是在以房角后房型人工晶状体植入为金标准的时代,对UGH综合征的临床病程和危险因素进行特征描述。

患者与方法

这是一项对2014年1月至2018年9月间诊治的30例UGH综合征患者的回顾性研究。分析了初始临床检查数据、所涉及的人工晶状体类型及临床治疗情况。

结果

纳入28例患者的30只眼。人工晶状体的植入位置为虹膜缝合固定(15/30,50%)、囊袋内(6/30,20%)、巩膜固定(4/30,13.3%)、睫状沟内(3/30,10%)或“进出型”(2/30,6.7%)。初始治疗为药物治疗(18只眼)或手术治疗(12只眼)。手术方式包括人工晶状体取出术(n = 4)、人工晶状体复位术(n = 7)或小梁切除术(n = 1)。药物治疗组出现复发(9/18),而手术组未出现复发(p = 0.02)。30例中有19例(63.3%)发生慢性高眼压。

结论

任何类型的人工晶状体都可能导致UGH综合征。囊袋内人工晶状体植入并不能排除该诊断。尽管前房型人工晶状体植入的应用逐渐减少,但UGH综合征仍是一种常见病症,必须予以认识以便调整治疗方案。

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