摘要
目的探讨毒性前节综合征（TASS）的发病原因、临床表现、治疗方法及预后。方法本研究为系列病例研究，回顾性分析8例TASS患者的临床资料。结果7例为白内障术后、1例为角膜穿通伤术后病例。发病原因：3例因手术器械碘伏浸泡后未冲洗干净而发生，2例因白内障术中灌注液误用蒸馏水而发生，2例因术毕时结膜下注药反流进入前房而发生，1例因术后前房注药误用注射用水配制而发生。发病时间：3例在手术中发病，5例在术后1d发病。8例均有无痛性视物模糊（100％）。术中发生的3例均表现为角膜透明性降低，虹膜大量脱色素。术后1d时，8例患者均表现为弥漫的角膜基质水肿和严重的前葡萄膜炎。所有病例均给予0．1％地塞米松或1％醋酸泼尼松滴眼液滴眼，4次／d至1次／h。眼压升高的患者加用2％卡替洛尔滴眼液，2次／d。预后：2例患者发生角膜内皮失代偿，6例角膜恢复透明。结论各种毒性物质误入前房可导致TASS，这些情况都是可以避免的。早期诊断和正确治疗可能会改善预后。
Objective To investigate the etiology, clinical features, treatment and prognosis of toxic anterior segment syndrome （TASS）. Methods It was a retrospective series case study. The clinical data of eight definite diagnosed TASS cases were retrospectively analyzed. Results Among eight TASS cases, seven were post cataract surgery cases and one was post cornea penetrating injury. Three cases were caused by residual povidone iodine on instruments, 2 cases resulted from the misuse of distilled water as intraocular irrigating liquid during cataract surgery, 2 cases were produced by the countercurrent of antibiotic solution via the cornea-scleral incision into anterior chamber during subconjunctival injection at the end of the surgery, and 1 case was induced by the injection of the distilled water into the anterior chamber at the end of the surgery. Three TASS cases occurred during operation and 5 cases occurred at 1 day after operation. All eight cases suffered from the painless blurred vision. Three cases occurred during operation presented with decrease of corneal transparence and depigmentation of iris. On the first day after operation, all cases had diffuse corneal stroma edema and severe anterior uveitis. Dexamethasone 0.1% or prednisolone acetate 1% eye drops, three times per day or one time per hour was used in all cases. Carteolol 2% eye drop, two times per day, was used for the cases with ocular hypertension. The cornea was clear in 6 cases, but corneal endothelial decompensation in 2 cases after therapy. Conclusion Various toxic agents injected into anterior chamber by misuse can result in TASS. All these misuse can be avoided. Early diagnosis and proper management may be important to improve the prognosis of TASS.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2009年第3期225-228,共4页
Chinese Journal of Ophthalmology
关键词
眼前半段
手术后并发症
炎症
白内障摘除术
Anterior eye segment
Postoperative complications
Inflammation
Cataract extraction
