儿童先天性白内障术后视觉发育观察  

Visual development following congenital cataract extraction

作　　者：龚淑贤[1] 王勇[1] 陈丹[1] 黄华林[1] 张炯[1] 张莹[1] 

机构地区：[1]武汉爱尔眼科医院,武汉430063

出　　处：《临床眼科杂志》2007年第3期215-218,共4页Journal of Clinical Ophthalmology

摘　　要：目的：评价儿童先天性白内障摘除及人工晶状体光学部后囊夹持植入术后联合视功能训练的疗效。方法：将连续收集73例（129只眼）3～6岁的儿童分为三组，治疗组31例（50只眼）为先天性白内障组，均行白内障摘除联合人工晶状体光学部后囊夹持植入术，术后行弱视治疗；对照组1共23例（41只眼）为屈光不正性弱视儿童；对照组2共19例（38只眼）为视觉发育正常儿童。三组治疗前后或观察前后均进行最佳矫正远视力（BCDVA）、屈光度、视觉诱发电位（VEP）、光学相干断层成像（OCT）及同视机的检查。随访期为6—24个月。结果：（1）先天性白内障术后BCDVA明显高于术前BCDVA，差异具有统计学意义（P〈0．05）。（2）双眼白内障术后视功能与单眼白内障术后视功能差异无统计学意义（P〉0．05）。（3）治疗组与对照组1的VEP中P100的振幅和潜伏期差异无统计学意义（P〉0．05），但两组与对照组2的VEP中P100的振幅和潜伏期比较差异有统计学意义（P〈0．05）。（4）先天性白内障术后视觉高级功能恢复为Ⅰ级视功能6例（19．35％），同时具有Ⅰ和Ⅱ级视功能2例（6．45％），同时具有Ⅰ、Ⅱ和Ⅲ级视功能10例（32．25％），无视觉功能13例（41．94％）。双眼和单眼白内障在视功能的恢复上差异无统计学意义（P〉0．05）。（5）先天性白内障术后检测黄斑厚度分别与两对照组比较差异无统计学意义（P〉0．05）。（6）随访期间白内障手术组均未见后囊混浊发生。结论：先天性白内障儿童行白内障摘除联合人工晶状体光学部后囊夹持植入术后积极治疗弱视，可促进视觉发育，使儿童获得满意的视功能。Objective To evaluate the visual development following posterior continuous eurvilinear eapsulorhexis with optic capture of the posterior chamber intraocular lens in congenital cataract. Methods 73 eases with 129 eyes （ 3 ～6 years old ） are divided three groups. 31 eases （50eyes） with congenital cataract were enrolled in study group, which were performed posterior continuous eurvilinear eapsulorhexis with optic capture of the posterior chamber intraocular lens. 23 eases （41 eyes） with refractive error amblyopia were enrolled in control 1 group. 19 eases （38eyes） with normal visual function were enrolled control 2 group. All the eases accepted the examination of best corrected distant visual acuity （ BCDVA ） , visual evoked response （VEP） , optical coherence tomography （OCT）. Follow-up period is 6 months to 24 months. Results （ 1 ） In cataract team, the BCDVA after surgery was significantly better than that of before surgery （ P 〈 0.05 ）. （ 2 ） There was no difference in visual acuity between bilateral cataract and unilateral cataract （ P 〉 0.0：5 ）. （3）The amplitude and latency of Pl00 wave in PRVEP in cataract team and amblyopia team had no difference （ P 〉0.05 ）. （4）18 in 31 patients （58.06%） with congenital cataract who had PCCC with IOL implant ended up with gross or fine stereopsis. （5）CMT （ central macular thickness） in three teams had no difference. （6） The eyes with optic capture were not found optic axis opaque. Conclusion Patients of congenital cataract undergo PCCC with optic capture of the posterior chamber IOL and aggressive rehabilitation after surgery can get satisfied visual function, what＇s more, the development of retina will not be interfered.

关 键 词：儿童 先天性白内障 视觉发育 

分 类 号：R779.66[医药卫生—眼科]