迟发性、散发性眼前节毒性综合征临床分析

发布时间：2018-01-31 01:03

本文关键词： 眼前节毒性综合征迟发性散发性炎症反应白内障　出处：《眼科新进展》2014年10期 　论文类型：期刊论文

【摘要】：目的探讨散发性、迟发性眼前节毒性综合征(toxic anterior segment syndrome,TASS)的发病原因、临床表现、治疗方法及预后。方法回顾性分析我院2011年3月至2013年9月治疗的散发性、迟发性TASS 10例患者的临床资料。结果手术方式:白内障超声乳化吸出联合人工晶状体植入术8例,白内障皮质抽吸联合人工晶状体植入术2例。发病原因:人工晶状体源性5例,前房纤维性异物1例,无明显原因4例。TASS发生时间为术后(6.0±0.4)d,其中术后4 d者1例,5~7 d者7例,7 d者2例。临床表现:1例中度、9例重度,其中2例患儿前房内纤维素渗出明显较成人严重。治疗:轻度采用妥布霉素地塞米松眼液滴眼,每2 h 1次,妥布霉素地塞米松眼膏涂眼;中度和重度:结膜下注射地塞米松2 mg,每天1次,连续3~5 d,复方托吡卡胺散瞳,每天3次,必要时加用散瞳合剂,余治疗同轻度。治疗3d后症状不能缓解者全身加用类固醇激素。治疗后随访1个月~1 a,所有患者经治疗后前房内炎症反应消退、纤维素渗出吸收,角膜恢复透明,但瞳孔散大,光反射消失;2例患儿后发性白内障形成。术后3个月经Nd:YAG激光后囊膜切开术后视力提高,但存在畏光、眩光等并发症。结论散发性、迟发性TASS可能与人工晶状体类型、进入眼内的异物有关,但也可能存在个体差异。
[Abstract]:Objective to investigate the pathogenesis and clinical manifestations of sporadic anterior segment syndrome (TASS). Methods the sporadic treatment from March 2011 to September 2013 in our hospital was retrospectively analyzed. Clinical data of 10 patients with delayed TASS. Results: phacoemulsification combined with intraocular lens implantation was performed in 8 cases. There were 2 cases of cataract cortical aspiration combined with intraocular lens implantation. The causes were intraocular lens origin in 5 cases and fibrous foreign body in anterior chamber in 1 case. The time of occurrence of TASS was 6. 0 卤0. 4 days after operation, of which 1 case had 5 or 7 days after operation, 7 cases had 7 days and 1 case had moderate clinical manifestation. 9 cases were severe, of which 2 cases had more severe cellulose exudation in the anterior chamber than adults. Treatment: topamicin dexamethasone eye drops every 2 hours, tobramycin dexamethasone eye ointment was applied to the eyes. Moderate and severe: subconjunctival injection of dexamethasone 2 mg, once a day for 3 days for 5 days, compound topiramine mydriasis, 3 times a day, if necessary, add mydriasis mixture. The remaining treatment was mild. After 3 days of treatment, the patients who could not relieve their symptoms were treated with steroid hormone. The patients were followed up for 1 year for 1 month. After treatment, the inflammatory reaction in the anterior chamber subsided and the cellulose exudate was absorbed. The cornea was transparent, but the pupil was dilated and the light reflection disappeared. The visual acuity was improved after 3 months after Nd:YAG laser posterior capsulorotomy, but there were some complications such as photophobia and glare. Delayed TASS may be related to intraocular lens type and intraocular foreign body entry, but may also have individual differences.
【作者单位】：贵州省人民医院眼科;
【基金】：贵州省科学技术基金资助(编号:2007-2114)~~
【分类号】：R779.66
【正文快照】： 眼前节毒性综合征(toxic anterior segment syn-drome,TASS)是一种眼前节的无菌性炎症反应,多发生于顺利的白内障手术,多为群发性,少数为散发。因治疗方案不同,及时将它与感染性眼内炎进行鉴别诊断至关重要。TASS除结膜充血较轻、疼痛不剧烈、角膜缘的角膜水肿、继发性青光

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