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色素性视网膜炎并发复杂性白内障的综述:发病机制与白内障手术

A Review of Complicated Cataract in Retinitis Pigmentosa: Pathogenesis and Cataract Surgery.

作者信息

Hong Yingying, Li Hongzhe, Sun Yang, Ji Yinghong

机构信息

Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.

NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.

出版信息

J Ophthalmol. 2020 Dec 21;2020:6699103. doi: 10.1155/2020/6699103. eCollection 2020.

Abstract

Retinitis pigmentosa (RP) is a set of inherited retinal degenerative diseases that affect photoreceptor and retinal pigment epithelial cells (RPEs), possibly associated with some ocular complications, including cataract. The complicated cataract formation is most likely the result of RP-related inflammation response, and the most common morphology category is posterior subcapsular cataract (PSC). Despite the absence of curative pharmacologic treatment, phacoemulsification with intraocular lens implantation to deal with opacification in the lens is preferred due to the considerable visual outcomes. However, the incidence of intraocular and postoperative complications is higher in RP patients than those without, including intraoperative phototoxic retinal damage, posterior capsular opacification (PCO), capsular contraction syndrome (CCS), pseudophakic cystoid macular edema (PCME), increased postoperative intraocular pressure (IOP), and intraocular lens (IOL) dislocation. Hence, it needs much attention to surgery progress and close follow-up. In this review, we discuss the current understanding of RP patients with complicated cataracts from morphology to potential pathogenesis to cataract surgical procedure and provide a concise description and the recommended management of related surgery complications to broaden the knowledge and lower the latent risks to yield better clinical outcomes.

摘要

视网膜色素变性(RP)是一组遗传性视网膜退行性疾病,会影响光感受器和视网膜色素上皮细胞(RPE),可能伴有一些眼部并发症,包括白内障。复杂白内障的形成很可能是RP相关炎症反应的结果,最常见的形态类型是后囊下白内障(PSC)。尽管缺乏治愈性药物治疗,但由于显著的视觉效果,超声乳化联合人工晶状体植入术来处理晶状体混浊仍是首选。然而,RP患者眼内及术后并发症的发生率高于非RP患者,包括术中光毒性视网膜损伤、后囊膜混浊(PCO)、囊袋收缩综合征(CCS)、人工晶状体性黄斑囊样水肿(PCME)、术后眼压(IOP)升高以及人工晶状体(IOL)脱位。因此,需要密切关注手术进展并进行密切随访。在本综述中,我们讨论了目前对患有复杂白内障的RP患者从形态学到潜在发病机制再到白内障手术过程的理解,并对相关手术并发症进行简要描述和推荐管理,以拓宽知识并降低潜在风险,从而产生更好的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7458/7803180/a907220e0ff7/joph2020-6699103.001.jpg

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