Comparative analysis of the eye function and complications after removal of complicated cataract due to uveitis and senile cataract.
Comparative analysis of the eye function and complications after removal of complicated cataract due to uveitis and senile cataract.
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发表时间：
2005
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通讯作者：
P. Jurowski;R. Goś;Katarzyna Kaszuba-Bartkowiak;Alicja Zeman-Miecznik
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作者：
P. Jurowski;R. Goś;Katarzyna Kaszuba-Bartkowiak;Alicja Zeman-Miecznik
目的回顾、对比分析葡萄膜炎并发白内障与老年性白内障的手术效果。材料与方法将纳入本研究的白内障患者分为两组。第一组为葡萄膜炎并发白内障30眼。葡萄膜炎的主要病因为类风湿性关节炎8只眼，强直性脊柱炎7只眼，赖特综合征3只眼，银屑病3只眼，系统性结节病2只眼，外伤后葡萄膜炎1只眼。老年性白内障组30只眼。两组各有5例合并青光眼。两组均行超声乳化或吸出折叠式三片人工晶状体植入术。随访期12个月。考虑最佳矫正视力和术中、术后并发症。结果两组患者在性别、白内障硬度方面差异无统计学意义。显著年轻的患者在第1组P<；0.01。卑鄙的术前。/后停。视力2组优于1组，分别为0.4/0.8和0.2/0.5，p<；0.01。然而，在这两组中，合并青光眼的患者的术前视力显著最低：第一组，0.1p；0.01，第二组：0.25p；0.001。术中并发症发生率：角膜烧伤分别为10%和6.6%，局部括约肌损伤分别为10%和0%，悬韧带断裂分别为10%和3.3%。术后晚期，1组并发症发生率高于2组，分别为继发性白内障50%和13.3%，人工晶状体偏心40%和6.6%，囊膜收缩80%和10%，青光眼10%和3.3%。葡萄膜炎复发率为30%。结论现代显微手术技术和人工晶状体植入术治疗老年性白内障效果显著，但合并葡萄膜炎的白内障手术仍存在并发症。未来葡萄膜炎并发白内障的手术策略必须包括最合适的合格标准，例如，选择最合适的手术时机和最方便的手术方法，以及最有效的围手术期抗炎治疗。
PURPOSE retrospective, comparative analysis of the effectiveness of the results among patients who underwent removal of complicated cataract due to uveitis and senile cataract. MATERIAL AND METHODS Patients with cataract enrolled in this study were divided into two groups. Group 1 comprised 30 eyes with complicated cataract due to uveitis. The main causes of uveitis were: rheumatoid arthritis in 8 eyes, ankylosing spondylitis in 7, Reiter syndrome in 3, psoriatic arthritis in 3, systemic sarcoidosis in 2, post-traumatic uveitis in 1. In 6 patients (6 eyes) the etiology of uveitis was unknown. Group 2 comprised 30 eyes with senile cataract. In 5 patients in each group there were coexisting glaucoma. In both groups phacoemulsification or phacoaspiration and foldable three piece IOL implantation were performed. The follow-up period was 12 months. Best corrected visual acuity and intra and postoperative complications were taken into consideration. RESULTS There were no differences in gender and cataract hardness between the two groups. Significantly younger patients were in group 1 p< 0.01. Mean preop./ postop. visual acuity was better in group 2 as compared with group 1: 0.4/ 0.8 and 0.2/ 0.5, respectively, p < 0.01. In both groups however, the preoperative visual acuity was significantly lowest in patients with coexisting glaucoma: group 1, 0.1 p < 0.01 and in group 2: 0.25 p < 0.001. Significantly more frequent intraoperative complications were observed in group 1 as compared with group 2 e.g., corneal burn 10% and 6.6%, local sphincter damage 10% and 0%, zonular rupture 10% and 3.3% respectively. Similarly, in the late postoperative period more frequent complications were observed in group 1 than in group 2 e.g.: secondary cataract 50% and 13.3%, IOL decentration 40% and 6.6%, capsule contraction 80% and 10%, glaucoma 10% and 3.3% respectively. Recurrence of uveitis was observed in 30% of eyes in group 1. CONCLUSIONS Although the modern microsurgical technology and IOL implantation have led to more effective treatment of senile cataract, the surgery of complicated cataract due to uveitis is still not free from complications. Future surgical strategy of complicated cataract owing to uveitis has to comprise the most adequate qualification criteria e.g. choice of the optimal period for surgery and the most convenient surgical technique as well as the most effective perioperative anti-inflammatory treatment.