目的: 报告1例飞秒激光治疗移植物抗宿主病相关性白内障患者。方法: 对一名男性异基因造血干细胞移植术后2年患者的白内障情况进行诊治并追踪。患者, 男, 29 岁, 异基因造血干细胞移植术后2年, 双眼视力渐进性下降1年余, 影响日常自理生活。眼部体征: Vod:0.06→0.2, Vos:CF/眼前(矫不应); NCT:R 11.2 mmHg, L 16.7 mmHg, 泪液分泌试验: R 5 mm/5 min, L 2 mm/5 min, 双眼结膜混合充血(++++), 右眼晶体后囊下皮质呈砂锅底样混浊; 左眼角膜中央实质层云雾状混浊并见大量新生血管, 晶体全白色混浊。诊断: 1.双眼并发性白内障, 2.左眼角膜斑翳, 3.慢性移植物抗宿主病, 4.急性淋巴细胞性白血病, 5.异基因造血干细胞移植术后, 6.糖尿病。予右眼行白内障超声乳化摘除联合人工晶体植入术, 左眼行飞秒激光辅助白内障超声乳化摘除联合人工晶体植入术。结果: 患者术后视力Vod: 0.4, Vos: 0.04, 目前患者生活自理已完全不受影响。结论: 飞秒激光辅助白内障超声乳化摘除联合人工晶体植入术对特殊患者亦具有很高的安全性及手术效果。

Purpose: The examination of the effects of second generation lotrafilcon B silicone hydrogel (SiH) lenses on the cornea when worn for three years of daily wear. Material and Methods: 55 healthy patients were divided into two groups: current hydrogel contact lens wearers refitted with lotrafilcon B lenses (Group 1; 28 patients) and neophyte contact lens wearers (Group 2; 27 patients). Each patient's subjective eye comfort was measured with a self-administered questionnaire. The corneas were analyzed using contact specular microscope to measure corneal thickness and the endothelium before the SiH lenses were fitted after four weeks, one month, six months, one year, two years, and three years of lens wear. Results: Subjective complaints of patients in Group 1 were reduced; however patients in Group 2 experienced discomfort during the first two to four weeks of use. In Group 1, objective examinations identified a decrease in endothelial cell density. In Group 2, the endothelial cell density increased slightly in the first two years but decreased after three years. The results indicate that lotrafilcon B slows down the deleterious effects of contact lenses. The coefficient of variation significantly decreased after six months in Group 1 (0.47 vs 0.44; p = 0.049), whereas, in Group 2, the hexagonal cells improved significantly after one month (27.78 vs 28.25; p = 0.025). Conclusion: Based on the subjects involved and the period of time under examination, it can be concluded that high-Dk SiH lenses support the physiological metabolism and functions of the cornea by improving oxygen provision.