儿童白内障不同术式的临床观察  

Clinical Study of Three Different Cataract Surgeries in Children

作　　者：宫献珍[1] 

机构地区：[1]河北省邢台市眼科医院,054001

出　　处：《中国眼耳鼻喉科杂志》2006年第1期38-39,共2页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨儿童白内障的最佳手术方式方法对136例(204眼)儿童白内障实施经上方巩膜隧道切口的超声乳化白内障吸出及后房型人工晶状体植入术。根据对后囊不同的处理方法,分为三组:Ⅰ组行后囊抛光,保留完整的后囊;Ⅱ组行后囊环行撕囊;Ⅲ组行后囊环行撕囊联合前部玻璃体切除术。术后随访12～24个月,平均20个月。观察各组术后矫正视力、后发性白内障发生情况及其它并发症。结果三组白内障术后后发障的发生率分别为Ⅰ组66.00%;Ⅱ组31.58%;Ⅲ组1.28% 术后矫正视力≥0.5者Ⅰ组10眼,占20.83%;Ⅱ组48眼,占66.67%;Ⅲ组64眼占80.05%。无黄斑水肿、视网膜脱离等并发症的发生。结论儿童白内障吸出后房型人工晶状体植入术中,行后囊连续环行撕囊联合前部玻璃体切除术可有效预防儿童白内障术后后发性白内障的发生。Purpose To study the optimum surgical method on cataract in children.Methods Phacemulsification and implantation of posterior chamber intraocular lens through scleral tunnel incision was performed on 136 cases （204 eyes） with cataract in children. All cases were divided into three groups. Group Ⅰ was treated with phacoerysis. Group Ⅱ with posterior continuous curvilinear capsulorhexis （PCCC）.Group Ⅲ with PCCC and anterior vitrectomy. Post-operatively, the visual acuity, secondary cataract and other complications were followed up for 20 months（ range 12-24 months）. Results The rate of occurrence of secondary cataract was 66.00% in the group Ⅰ , 31.58% in the group Ⅱ , 1.28% in the group Ⅲ. The best corrected visual acuity ≥0.5 after operation： 10 eyes （20.83%） in the group Ⅰ , 48 eyes （66.67%） in the group Ⅱ , 64 eyes （80.05 % ） in the group Ⅲ. No complication, such as cystoid macular edema, retinal detachment, etc. was found. Conclusion Phacoerysis combined with PCCC and anterior vitrectomy and IOL implantation is safe. It can effectively prevent the occurrence of secondary-cataract in children.

关 键 词：后发性白内障 后囊环行撕囊 前部玻璃体切除术 

分 类 号：R779.66[医药卫生—眼科] R776.1[医药卫生—临床医学]