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目的:报告1例年长患者因梅毒继发的术后葡萄膜炎。方法:一例76岁的马来西亚男性患者,双眼为未成熟期白内障,右眼顺利进行了白内障超声乳化术,既往无葡萄膜炎病史。术后5d,右眼突然出现视物模糊,眼部检查发现角膜弥漫性水肿、中度前房反应和眼压升高。结果:局部应用抗生素和类固醇药物效果良好,眼压经用抗青光眼药得到控制。然而,术后3wk,右眼再次发生疼痛、红肿、视物模糊,眼部检查显示严重的前葡萄膜炎伴有羊脂状角膜后沉积物出现,VDRL和TPHA阳性证实为梅毒,通过全身注射青霉素类药物和局部应用类固醇药物,病情明显好转。结论:这个病例证明在年长患者梅毒是未被充分认识的引起术后葡萄膜炎的病因,应用青霉素可获得快速显著的治疗效果。
OBJECTIVE: To report postoperative uveitis secondary to syphilis in 1 elderly patient. METHODS: A 76-year-old male patient in Malaysia with binocular premature cataracts and phacoemulsification with a history of no history of uveitis. 5d after surgery, the right eye suddenly appeared blurred vision, cornea found diffuse edema, moderate anterior chamber reaction and elevated intraocular pressure. RESULTS: Topical antibiotics and steroids were effective and IOP was controlled with anti-glaucoma medication. However, 3wk postoperatively, pain, redness and blurred vision in the right eye occurred again. Ocular examination showed severe anterior uveitis associated with posterior ascorbate deposits. VDRL and TPHA were confirmed as positive for syphilis by systemic injection Penicillin drugs and topical steroid drugs, the condition improved significantly. CONCLUSIONS: This case demonstrates that syphilis is not well understood in elderly patients and causes etiological postoperative uveitis. Rapid and significant treatment with penicillin is indicated.