白内障超声乳化吸除联合人工晶状体植入术对慢性葡萄膜炎炎症的影响：一项纵向激光散射细胞光度术研究

Effect of cataract surgery with intraocular lens implantation on inflammation in chronic uveitis: a longitudinal laser flare photometry study.

作者信息

Tran V T, Guex-Crosier Y, Herbort C P

机构信息

Department of Ophthalmology, Hôpital Jules Gonin, University of Lausanne, Switzerland.

出版信息

Can J Ophthalmol. 1998 Aug;33(5):264-9.

PMID:9740955

Abstract

BACKGROUND

The precise effect of cataract surgery with implantation of an intraocular lens (IOL) on the course of uveitis is not well known. Laser flare photometry allows quantitative assessment of intraocular inflammation. The aim of this study was to determine the effect of cataract surgery with IOL implantation on the disease course and level of inflammation in chronic uveitis, using laser flare photometry monitoring.

METHODS

The charts of all patients who underwent surgery for secondary uveitic cataract between 1990 and 1994 (24/558 [4.3%]) were reviewed. Only eyes that had received standardized perioperative steroid treatment and had systematic laser flare photometry follow-up were included. Cataracts due to Fuchs' heterochromic cyclitis were excluded. Visual acuity, flare values and recurrence of flare episodes were compared before and after cataract surgery, and postoperative data were compared between eyes that received heparin-coated IOLs and those that received uncoated IOLs.

RESULTS

Nineteen eyes of 16 patients met the inclusion criteria. The mean length of the pre- and- postoperative follow-up periods was 779 and 444 days respectively. The mean visual acuity increased from 0.2 (standard error of the mean [SEM] 0.2) preoperatively to 0.8 (SEM 0.3) postoperatively (p < or = 0.001). The mean flare value decreased from 58.6 (SEM 18.6) photons/ms during preoperative follow-up to 29.7 (SEM 7.8) photons/ms during postoperative follow-up (p < or = 0.006). The mean number of recurrences per 6 months decreased from 0.27 (SEM 0.03) preoperatively to 0.12 (SEM 0.01) postoperatively (p < or = 0.05). The difference in the postoperative recurrence rate between the eyes that received coated IOLs (0.0) and those that received uncoated IOLs (0.18 [SEM 0.02]) approached statistical significance (p < or = 0.054).

INTERPRETATION

Quantitative assessment of inflammation by laser flare photometry in patients undergoing surgery for uveitic cataract showed that there was significantly less inflammation and fewer recurrences postoperatively and that recurrences were less severe.

摘要

背景

白内障手术联合人工晶状体（IOL）植入对葡萄膜炎病程的确切影响尚不清楚。激光散射光度法可对眼内炎症进行定量评估。本研究的目的是通过激光散射光度法监测，确定白内障手术联合IOL植入对慢性葡萄膜炎疾病病程和炎症水平的影响。

方法

回顾了1990年至1994年间接受继发性葡萄膜炎性白内障手术的所有患者的病历（24/558 [4.3%]）。仅纳入接受标准化围手术期类固醇治疗并进行系统性激光散射光度法随访的眼睛。排除因富克斯异色性睫状体炎导致的白内障。比较白内障手术前后的视力、散射值和散射发作复发情况，并比较接受肝素涂层IOL的眼睛与接受未涂层IOL的眼睛的术后数据。

结果

16例患者的19只眼睛符合纳入标准。术前和术后随访期的平均时长分别为779天和444天。平均视力从术前的0.2（平均标准误差[SEM] 0.2）提高到术后的0.8（SEM 0.3）（p≤0.001）。平均散射值从术前随访期间的58.6（SEM 18.6）光子/毫秒降至术后随访期间的29.7（SEM 7.8）光子/毫秒（p≤0.006）。每6个月的平均复发次数从术前的0.27（SEM 0.03）降至术后的0.12（SEM 0.01）（p≤0.05）。接受涂层IOL的眼睛（0.0）与接受未涂层IOL的眼睛（0.18 [SEM 0.02]）术后复发率的差异接近统计学意义（p≤0.054）。