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小儿吸虫性肉芽肿性葡萄膜炎合并复杂性白内障的手术疗效

Surgical outcomes of complicated cataract with pediatric trematode granulomatous uveitis.

作者信息

Farouk Mahmoud M, Mounir Amr, Abozaid Mortada Ahmed, Mostafa Engy Mohamed, Abdellah Marwa Mahmoud

机构信息

Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag 82524, Egypt.

出版信息

Int J Ophthalmol. 2023 Mar 18;16(3):354-360. doi: 10.18240/ijo.2023.03.04. eCollection 2023.

Abstract

AIM

To describe the clinical characteristics and surgical outcomes of complicated cataract with pediatric trematodal granulomatous uveitis (TGU).

METHODS

Patients of cataract with TGU in the membranous (inactive) stage underwent cataract surgery with intraocular lens (IOL) implantation. Preoperative history and ophthalmic examination were conducted for all cases, whereas Schimphlug imaging and corneal topography were done for some patients. Postoperative follow up was done on the 1, 2, and 5 postoperative days after surgery. Then, it was done at least at one, three, and six months postoperatively. Intraoperative and postoperative complications and the methods of their management were reported.

RESULTS

Twelve eyes of 12 male children were included in this study ranging from 8 to 16y. The mean best corrected Snellen visual acuity (BCVA) was significantly improved from 0.09±0.06 preoperatively to 0.37±0.11 at the final visit 6mo postoperatively (<0.001). Schimphlug imaging and corneal topography showed flattening of the anterior surface of the inferior cornea. Intraoperative difficulties and complications included the poor dilatability of the drown down pupil, strong posterior synechia between the anterior lens capsule and the iris at the site of the inferior retrocorneal vascularized membrane and hyphema. All cases underwent primary hydrophobic IOL implantation.

CONCLUSION

Surgery for this type of cataract is relatively safe and effective. It is associated with some specific difficulties and complications that should be considered during surgery and follow up.

摘要

目的

描述小儿吸虫性肉芽肿性葡萄膜炎(TGU)并发白内障的临床特征及手术效果。

方法

处于膜性(静止)期的TGU并发白内障患者接受白内障手术并植入人工晶状体(IOL)。对所有病例进行术前病史和眼科检查,部分患者进行了Scheimpflug成像和角膜地形图检查。术后分别在术后第1天、第2天和第5天进行随访,之后至少在术后1个月、3个月和6个月进行随访。报告术中及术后并发症及其处理方法。

结果

本研究纳入12例男性儿童的12只眼,年龄8至16岁。平均最佳矫正视力(BCVA)从术前的0.09±0.06显著提高至术后6个月最后一次随访时的0.37±0.11(<0.001)。Scheimpflug成像和角膜地形图显示下角膜前表面变平。术中困难和并发症包括瞳孔散大困难、下角膜后血管化膜部位晶状体前囊与虹膜之间强烈的后粘连以及前房积血。所有病例均进行了一期疏水IOL植入。

结论

此类白内障手术相对安全有效。手术及随访过程中应考虑一些特定的困难和并发症。

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