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目的:探讨葡萄膜炎并发白内障术中前房内注射地塞米松的疗效和安全性。方法:选择64例(64眼)葡萄膜炎并发性白内障患者,随机分成地塞米松组和对照组,每组均32例。两组均行白内障小切口非超声乳化囊外摘出+人工晶体植入术。地塞米松组术中前房内注入地塞米松注射液0.5 mg,对照组术中前房内注入复方平衡盐溶液。观察并比较两组患者术后前房纤维蛋白渗出情况、后囊浑浊的发生率及眼压变化。结果:地塞米松组术后前房以无渗出和轻度渗出为主,对照组术后前房轻、中、重度渗出的例数高于地塞米松组。地塞米松组术后的前房纤维蛋白渗出的发生率明显低于对照组(P<0.01)。地塞米松组术后出现后囊浑浊2例,且均为Ⅰ级,对照组术后出现后囊浑浊8例,其中Ⅰ级5例,Ⅱ级3例,地塞米松组术后后囊浑浊的发生率明显低于对照组(P<0.05)。两组术后眼压均无明显改变(P>0.05)。两组术中术后未发现视网膜脱离或黄斑水肿等并发症。结论:葡萄膜炎并发白内障术中前房内注射地塞米松,可减轻术后炎症反应,无严重的并发症发生,是一种安全、有效的方法。
Objective: To investigate the efficacy and safety of anterior chamber injection of dexamethasone in uveitis complicated with cataract surgery. Methods: Sixty-four patients (64 eyes) with congenital cataract were selected and randomly divided into dexamethasone group and control group, with 32 cases in each group. Both groups underwent cataract extraction with non-phacoemulsification and intraocular lens implantation. Dexamethasone group intraoperative injection of dexamethasone 0.5 mg anterior chamber, the control group intraoperative anterior chamber infusion of compound balanced salt solution. The postoperative anterior fibrin exudation, the incidence of posterior capsule opacification and changes of intraocular pressure were observed and compared. Results: In the dexamethasone group, there was no exudation and mild exudation in the anterior chamber. The number of exudative, moderate and severe anterior extremity in the control group was higher than that in the dexamethasone group. The incidence of anterior fibrin exudation in dexamethasone group was significantly lower than that in control group (P <0.01). There were 2 cases of posterior capsular opacification in the dexamethasone group, all of which were grade Ⅰ. There were 8 cases of posterior capsular opacification in the control group, including 5 cases of grade Ⅰ, 3 cases of grade Ⅱ, and posterior capsular opacification of dexamethasone group The incidence was significantly lower than the control group (P <0.05). There was no significant change in intraocular pressure in both groups (P> 0.05). No postoperative complications such as retinal detachment or macular edema were found in the two groups. Conclusions: Intradental injection of dexamethasone in uveitis complicated cataract surgery can reduce the postoperative inflammatory response, without serious complications, it is a safe and effective method.