婴幼儿先天性白内障手术后并发症的临床分析  

Clinical analysis of postoperative complications of infantile congenital cataract surgery

作　　者：肖伟[1] 赵岱新[1] 濮伟[1] 张劲松[2] 

机构地区：[1]中国医科大学附属盛京医院眼科,中国辽宁省沈阳市110003 [2]中国医科大学附属第四医院眼科,中国辽宁省沈阳市110032

出　　处：《国际眼科杂志》2009年第5期861-864,共4页International Eye Science

基　　金：中国辽宁省自然科学基金项目(No.20062099)~~

摘　　要：目的:探讨婴幼儿先天性白内障手术后并发症的相关因素。方法:对年龄在1.5～30月龄的婴幼儿105例(186眼)先天性白内障进行回顾性研究。按患儿接受手术时年龄分为4组:<3月龄为1组,4～6月龄为2组,7～12月龄为3组,13～30月龄为4组。患眼全部采用白内障皮质吸除+后囊膜连续环形撕囊(posterior coutinuous circular capsulourhexis,PCCC)+前段玻璃体切除术(anterior vitrectomy,AV)。术后随访6～30mo,观察术后近期(1mo内)及远期(最长30mo)的并发症发生情况。分析先天性白内障术后并发症的发生与手术方式及手术时患儿年龄等因素之间的关系。结果:术后1mo内,1组术后无晶状体青光眼发病率为25%,角膜水肿发生率为57%,前房纤维素性虹膜炎发生率为12%;2组分别为5%,31%及11%;3组分别为3%,24%及4%;4组分别为0,17%及4%;在术后3～30mo随访中发现,1组有51%术眼发生不同程度的虹膜粘连,占各组之首。结论:先天性白内障术后并发症的发生与手术时患儿的年龄及手术方式有关:对于联合后囊膜及前段玻璃体切除的婴幼儿白内障手术,年龄越小,术后无晶状体青光眼、角膜水肿及虹膜炎等并发症发生的机会越大。AIM： To evaluate the related factors of postoperative complications of infantile congenital cataract surgery. METHODS： A retrospective study of a consecutive case series of 105 cases （186 eyes） of infantile congenital cataract at the age of 1.5-30 months. A cataract extraction ＋ posterior continuous circular capsulorhexis （PCCC） ＋ anterior vitrectomy （AV） is performed for each operated eye. The postoperative follow up ranged from 6-30 months. Complications were carefully observed within 1 month till 30 months postoperatively. The relations between the complications and the operation method the surgeon used, and the ages the children received the surgery, were analyzed. RESULTS： Group 1（ 〈3 months group） shows the highest complication rate, include aphakic glaucoma （25%）, corneal edema （57%） and intraocular inflammatory reaction（12% ）, shortly after cataract surgery; group 2 （3-6 months） had less complications： 5%, 31% and 11%, respectively; group 3 （7-12 months, 3%, 24% and 4% and, group 4（13-30 months, 0,17% and 4%）. CONCLUSION： In infantile cataract surgery, the younger patients receive the surgery, the greater risk of postoperative complications will be.

关 键 词：婴幼儿先天性白内障 手术后并发症 后囊膜连续环形撕囊 前段玻璃体切割术 

分 类 号：R779.66[医药卫生—眼科]