目的:探讨肾移植术后白内障患者的眼部特征及超声乳化联合人工晶状体(IOL)植入术的结果。
方法:纳入肾移植术后白内障患者和接受超声乳化联合人工晶状体植入术的对照患者。所有患者均行超声乳化联合人工晶状体植入术。视敏度,眼内压,晶状体不透明度的类型,角膜内皮细胞密度,术前评估眼部生物学参数。视力预后,干眼症,超声乳化术后6个月监测术后并发症。
结果:我们分析了16例肾移植术后患者的25只眼和21例对照患者的30只眼。肾移植组白内障最常见的类型为后囊膜下,对照组最常见的白内障类型为皮质性白内障。角膜散光的显著差异,白色与白色的比例,两组之间观察角膜曲率测量值。两组术后视力均有明显改善。术后并发症,例如前囊和后囊混浊的程度以及掺钕钇铝石榴石激光囊切开术的发生率,在肾移植组中显著降低。此外,肾移植组有2眼继发性青光眼。
结论:这项研究表明,肾移植术后的白内障多为后囊下。大多数患者术后视力恢复良好,术后并发症发生率降低。提示超声乳化联合人工晶状体植入术安全有效,为肾移植术后多灶性人工晶状体植入术提供参考。
OBJECTIVE: To explore ocular characteristics of patients with cataracts after renal
transplantation and analyze the results of phacoemulsification combined with intraocular lens (IOL) implantation.
METHODS: Patients with cataracts after renal
transplantation and control patients who underwent phacoemulsification combined with IOL implantation were enrolled. All patients underwent phacoemulsification combined with IOL implantation. Visual acuity, intraocular pressure, type of lens opacity, corneal endothelial cell density, and ocular biological parameters were evaluated before surgery. Visual prognosis, dry eye, and postoperative complications were monitored for 6 months after phacoemulsification.
RESULTS: We analyzed 25 eyes of 16 patients after renal
transplantation and 30 eyes of 21 control patients. The most common type of cataract of renal
transplantation group was posterior subcapsular, while the most common type of cataract of control group was cortical. Significant differences in corneal astigmatism, white-to-white ratio, and keratometry values were observed between the groups. The postoperative visual acuity of both groups significantly improved following surgery. Postoperative complications, such as the degree of anterior and posterior capsule opacification and the incidence of a requirement of neodymium-doped yttrium aluminum garnet laser capsulotomy, were significantly lower in the renal transplantation group. Moreover, secondary glaucoma occurred in two eyes in the renal
transplantation group.
CONCLUSIONS: This study showed that cataracts after renal transplantation were mostly posterior subcapsular. Postoperative visual acuity recovered well in most patients, with reduced incidence of postoperative complications. This study suggested that phacoemulsification combined with IOL implantation was safe and effective, providing a reference for multi-focal IOL implantation in kidney transplant recipients.