儿童后发性白内障合并人工晶状体固定性瞳孔夹持的手术治疗  

Surgical management for complex severe posterior capsule opacification with intraocular lens pupillary capture in childhood

作　　者：吴明星[1] 刘奕志[1] 刘玉华[1] 张新愉[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2006年第1期70-72,共3页Chinese Journal of Practical Ophthalmology

基　　金：广东省自然科学基金(031724);广州市科技局重点攻关项目(2003-Z3-E0031)

摘　　要：目的探讨儿童严重后发性白内障合并人工晶状体固定性瞳孔夹持的合理的治疗方法及疗效。方法对14岁以下发生严重后发性白内障的患者中合并人工晶体固定性瞳孔夹持伴有严重的虹膜后粘连或瞳孔膜闭的12只眼进行后发性白内障切除、人工晶状体复位术,部分病人联合前段玻璃体切割术。对虹膜后粘连或瞳孔膜闭者同时进行粘连分离或瞳孔成形术。结果12只眼成功分离虹膜与囊膜粘连并进行后发性白内障切除和人工晶状体复位。其中2只眼行瞳孔成形术,8只眼行前段玻璃体切割术,术后视功能有不同程度的改善。结论伴有严重人工晶状体瞳孔夹持和虹膜粘连或瞳孔膜闭的儿童严重后发性白内障的理想治疗手段是手术切除后发性白内障并进行人工晶状体复位。Objective To investigate the .optimal method to manage severe posterior capsule opacification accompanied intraocular lens （IOL） pupillary capture in childhood after cataract extraction and IOL implantation. Methods Posterior capsulotomy and IOL reposition were performed in 12 eyes with severe posterior capsule opacification accompanied intraocular lens pupil capture and severe iris posterior syneehia under 14 year - old. The posterior iris synechia was separated and the pupillary membrane was excised in some corecleisis cases. Anterior vitrectomy was combined in some cases. Results Posterior capsulotomy and the IOL reposition were successfully performed in all 12 cases. Severe posterior synechia of iris with posterior capsule was separated completely. The pupilloplasty were successfully accomplished in 2 cases with pupillary closure （seclusion of pupil） or occlusion of pupil （corecleisis） respectively. The anterior vitrectomy was also performed in 8 cases. The visual acuity in all cases was improved in different extent. Conclusions The ideal therapy for complex severe posterior capsule opacification with intraocular lens pupil capture caused by severe iris posterior synechia or pupillary membrane was secondary posterior capsulotomy and intraocular lens reposition.

关 键 词：后发白内障 人工晶状体 瞳孔夹持 儿童 

分 类 号：R776.1[医药卫生—眼科] R779.6[医药卫生—临床医学]