葡萄膜炎并发白内障术中前房注射长效糖皮质激素的疗效

摘要

•AIM: To analyze the clinical effect of adjuvant therapy with glucocorticoid in surgical treatment of uveitis complicated cataract. In order to provide reference for clinical diagnosis and treatment.• METHODS: Clinical data of patients with uveitis complicated cataract who received treatment at our hospital from 2013 to 2015 were analyzed. Patients were divided into two groups by different therapies, Group A:intraoperative injection with triamcinolone, Group B:without treatment of triamcinolone. The near and future curative effect in the two groups patients were compared.•RESULTS: A total of 68 patients were analyzed, Group A had 35 cases ( 37 eyes ) , Group B had 33 cases ( 34 eyes) . Group A patients had a higher rate of patients with a corrected visual acuity more than 0. 5 than that of Group B patients (χ2=4. 094, P=0. 043). There was no significant difference in intraocular pressure between the two groups ( P > 0. 05 ). Anterior chamber inflammation of the observation group patients were lower than the control group, the difference was statistically significant (χ2 =15. 900, P= 0. 001). Seven days after surgery, Group A patients had a higher levels of SOD in aqueous humour and lower levels of MDA and TNF-α in aqueous humour than these of Group B patients ( P> 0. 05 ). Group A patients had a lower 1 year recurrence rate than that of Group B patients (14%,5/35 vs 33%,11/33; Log-rank χ2=4. 004, P=0. 045). •CONCLUSION:Intraoperative anterior chamber injection with triamcinolone can significantly improve the curative effect in surgical treatment of uveitis complicated cataract.%目的：研究术中前房注射长效糖皮质激素是否能提高葡萄膜炎并发白内障手术的疗效,以期为临床诊疗提供参考。方法：分析2013-01/2015-01我院收治的接受手术治疗的葡萄膜炎并发白内障患者68例71眼的临床资料。依据治疗方法的不同分为观察组(术中前房注射曲安奈德,35例37眼)及对照组(术中不注射曲安奈德,33例34眼)。对比两组患者的疗效。结果：观察组术后1mo矫正视力>0.5比例显著高于对照组,差异有统计学意义(χ2=4.094,P=0.043)。两组术前及术后眼压比较均无统计学意义(P>0.05)。观察组患者术后前房炎症反应低于对照组,差异具有统计学意义(χ2=15.900,P=0.001)；术后1wk,观察组房水内SOD水平显著高于对照组,差异有统计学意义(P<0.05),而MDA及TNF-α水平显著低于对照组水平,差异有统计学意义( P<0.05)。观察组术后1a累积复发率显著低于对照组,差异有统计学意义(14%,5/35 vs 3%,11/33； Log-rank χ2=4.004,P=0.045)。结论：术中前房注射曲安奈德可显著提高葡萄膜炎并发白内障患者手术的疗效。