目的:探讨前房内注射曲安奈德(triamcinolone acetonide,TA)在外伤性白内障术中的安全性和有效性.方法:收集2013-01/2016-05的31例31眼外伤性白内障患者,行小切口非超声乳化白内障摘除手术,术中联合前房内注入TA,以帮助辨识是否有玻璃体脱出以及玻璃体所在位置.13例13眼被证实后囊膜完整,无玻璃体脱入前房患者,行小切口非超声乳化白内障摘除手术.18例18眼被证实伴有后囊膜破裂,玻璃体脱出患者行小切口非超声乳化白内障摘除联合前部玻璃体切除手术.术后随访6~12 mo.结果:所有病例均顺利完成手术.Ⅱ期角膜穿通伤患者均顺利植入人工晶状体.18例前房内注入TA证实伴有后囊膜破裂、玻璃体脱出者,在TA辅助下,明显改善了术中玻璃体皮质的辨识度,均彻底切除了前房的玻璃体.术后随访28例患者术后最佳矫正视力大于4.5.所有患者术后眼内炎症反应轻微,均未出现持续1 wk以上的高眼压及角膜水肿,人工晶状体位置居中,瞳孔位置居中.结论:曲安奈德前房内注射使得外伤性白内障手术更安全,术中后囊破裂及玻璃体脱出的处理更容易,同时可以抑制术后炎症反应.%·AIM: To evaluate the efficacy and safety of triamcinolone acetonide ( TA ) injected in anterior chamber during traumatic cataract surgery. ·METHODS: From January 2013 to May 2016, 31 cases ( 31 eyes ) of traumatic cataract were involved in our study. To identify whether there was vitreous loss and confirm the location of vitreous body, all the cases were injected TA into the anterior chamber respectively in surgery. Totally 13 cases (13 eyes) with intact posterior lens capsules were performed the small incision non-phacoemulsification cataract surgery. The others, 18 cases ( 18 eyes ) with posterior capsule rupture and vitreous loss were performed with the anterior vitrectomy combined with small incision non-phacoemulsification cataract surgery. The follow-up time was for 6-12mo. ·RESULTS: Tirty - one cases were completed the operation successfully. All the cases with second-stage penetrating corneal trauma were implanted intraocular lens(IOL). The other cases with first-stage penetrating corneal trauma were not implanted IOL. Eighteen cases, which were confirmed with posterior capsule rupture and vitreous loss by injecting TA into the anterior chamber, were consistently improved the visualization of vitreous cortex and treated with anterior vitrectomy successfully. During follow-up, 28 cases had best corrected visual acuity of more than 4. 5. The postoperative inflammation of all cases was slight. There was no hard corneal edema and abiding intraocular pressure higher more than 1wk. The position of the pupil and IOL was normal. ·CONCLUSION: Anterior chamber injection of TA can make the treatment of posterior capsule rupture and vitreous loss easier, and improve the safety of the traumatic cataract surgery. At the same time, it also can inhibit the postoperative inflammatory reaction.
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