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白内障手术联合玻璃体内注射地塞米松玻璃体内植入剂(Ozurdex)治疗葡萄膜炎性白内障。

Combination of cataract surgery with intravitreal injection of dexamethasone intravitreal implant (Ozurdex) for uveitis-induced cataract.

作者信息

Deng Jin, Sun Wen-Tao, Ai Hua, Wang Li-Ping

机构信息

Xi'an People's Hospital (Xi'an Fouth Hospital), Shaanxi Eye Hospital, Affiliated People's Hospital of Northwest University, Xi'an 710004, Shaanxi Province, China.

出版信息

Int J Ophthalmol. 2023 Mar 18;16(3):361-366. doi: 10.18240/ijo.2023.03.05. eCollection 2023.

Abstract

AIM

To evaluate the long-term results of patients with chronic uveitis-induced cataract by phacoemulsification with IOL implantation and intravitreal injection of dexamethasone (DEX) intravitreal implant (Ozurdex).

METHODS

The study included 32 eyes of 26 patients treated with DEX implant due to chronic uveitis-induced cataract and followed up for at least a year. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber reaction, central macular thickness (CMT), intraoperative and postoperative complications and uveitis recurrence were analyzed retrospectively.

RESULTS

A successful surgery was performed in all patients. The average follow-up period was 12mo. The female/male ratio was 13/13. Mean age was 45.65±3.83y (range 26 to 65y). Etiologically, rheumatic arthritis occurred in 6 patients (18.75%), ankylosing spondylitis in 4 (12.50%), HLA-B27 associated uveitis in 3 (9.38%), Vogt-Koyanagi-Harada-associated uveitis in 4 (12.50%) , Behcet's disease in 2 (6.25%), and 7 (21.88%) suffered from unknown diseases. All 32 eyes had varying degrees of improvement at 12mo after surgery, with 2 eyes showing BCVA of 0.1 or below (6.25%), 6 having 0.1-0.5 (18.75%), 18 of 0.5-1.0 (56.25%), and 6 of 1.0 or above (18.75%). No cases with increased IOP were observed. The values of mean CMT was increased at day 1, decreased at 1, 3mo after surgery and increased at 6, 12mo after surgery. No severe uveitis reactions, such as fibrinous exudates in the anterior chamber and exudative membrane formation on the anterior surface of the IOL, were observed after surgery.

CONCLUSION

The present studies show that intravitreal injection of Ozudex during cataract operation can provide a new option for the clinical treatment of uveitis-induced cataract.

摘要

目的

评估采用超声乳化白内障吸除联合人工晶状体植入术及玻璃体内注射地塞米松(DEX)玻璃体内植入剂(Ozurdex)治疗慢性葡萄膜炎性白内障患者的长期效果。

方法

本研究纳入26例因慢性葡萄膜炎性白内障接受DEX植入剂治疗且随访至少1年的患者的32只眼。回顾性分析最佳矫正视力(BCVA)、眼压(IOP)、前房反应、中心黄斑厚度(CMT)、术中和术后并发症以及葡萄膜炎复发情况。

结果

所有患者手术均成功。平均随访时间为12个月。男女比例为13/13。平均年龄为45.65±3.83岁(范围26至65岁)。病因方面,6例(18.75%)为风湿性关节炎,4例(12.50%)为强直性脊柱炎,3例(9.38%)为HLA - B27相关葡萄膜炎,4例(12.50%)为小柳原田综合征相关葡萄膜炎,2例(6.25%)为白塞病,7例(21.88%)病因不明。所有32只眼术后12个月均有不同程度改善,2只眼(6.25%)BCVA为0.1或更低,6只眼(18.75%)为0.1 - 0.5,18只眼(56.25%)为0.5 - 1.0,6只眼(18.75%)为1.0或更高。未观察到IOP升高的病例。平均CMT值在术后第1天升高,术后1、3个月降低,术后6、12个月升高。术后未观察到严重葡萄膜炎反应,如前房纤维素渗出和人工晶状体前表面渗出膜形成。

结论

本研究表明,白内障手术期间玻璃体内注射Ozurdex可为葡萄膜炎性白内障的临床治疗提供新选择。

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Decision-making and management of uveitic cataract.葡萄膜炎性白内障的决策与管理
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Management of cataract in uveitis patients.葡萄膜炎患者白内障的管理。
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