压贴球镜矫正婴幼儿先天性白内障术后无晶状体眼的疗效观察  

Clinical observation of press-on spherical lens on correction of aphakic eyes after congenital cataract

作　　者：陈利[1] 刘波[1] 

机构地区：[1]第三军医大学西南医院全军眼科中心,重庆市400038

出　　处：《眼科新进展》2009年第7期538-540,共3页Recent Advances in Ophthalmology

摘　　要：目的评价压贴球镜矫正婴幼儿先天性白内障术后无晶状体眼的最佳矫正视力及双眼视觉功能。方法将全身麻醉下行白内障针吸、后囊膜切开及前段玻璃体切割术的先天性白内障患儿8例(15眼),按年龄大小分成A组(年龄12～24个月)、B组(年龄3～11个月),术后1周均予压贴球镜联合框架眼镜全矫正配戴。观察术后1周、3个月、6个月、12个月2组患儿的视力、屈光度、双眼同时视情况。结果2组患儿术后最佳矫正视力均比术前有显著提高(P均<0.05)。术后1周、3个月、6个月、12个月A组屈光度分别为(18.79±3.47)DS、(19.36±3.44)DS、(19.07±3.18)DS、(20.38±0.48)DS;B组屈光度分别为(15.94±1.57)DS、(20.81±3.39)DS、(20.43±3.13)DS、(20.63±3.25)DS。A组各阶段屈光度变化平稳,B组术后3个月以后屈光度变化平稳。2组术后屈光度为+16.00～+21.00DS。15△棱镜底向外测试在术后6个月A组4例患儿建立了双眼同时视,B组1例患儿建立了同时视,A组检查结果优于B组;4△棱镜底向外试验示2组患儿眼位均无移动。结论压贴球镜联合框架眼镜全矫正,能有效解决患儿视功能发育关键期无晶状体眼的屈光不正,利于患儿术后视功能的重建。Objective To evaluate the best corrected visual acuity and binocular vision function of aphakic eyes after congenital cataract surgery by wearing press-on spherical lens in infants. Method Eight cases （ 15 eyes） with congenital cataract were operated with cataract aspiration, posterior capsulotomy, and anterior vitrectomy under general anesthesia. They were divided into two groups depending on ages, group A with the age from 12 months to 24 months,and group B with the age from 3 months to 11 months. One week after operation,they were fully corrected with press-on spherical lens attached to frame glasses. Diopter, visual acuity and binocular vision were observed at 1 week,3 months,5 months and 12 months after operation. Results Best corrected visual acuity of post-operative compared to that of pre-operative had statistical significance in both two groups（both P 〈0.05）. The diopter in group A after operation at each time was （18.79±3.47）DS, （19.36 ±3.44）DS, （19.07 ±3.18） DS, （20. 38 ±0.48） DS, respectively, and was （ 15. 94 ± 1.57 ） DS, （ 20. 81± 3.39 ） DS, （ 20. 43 ±3. 13 ） DS, （20. 63 ± 3.25 ） DS in group B, respectively. The diopter change was smooth in group A at each time,while the diopter in group B after postoperative 3 months were fluctuant placidly. Distribution range of diopter in two group was ＋ 16.00 DS to ＋ 21.00 DS. At 6 months after operation,4 cases in group A and 1 case in group B were established the binocular vision at 15 △ prism bottom-out test. Ocular position was without movement in both two groups at 4△prism bottom-out test. Conclusions Press-on spherical lens attached to flame glasses is effective to correct the refractive error of aphakic eyes in the critical period of visual function growth, and is useful for post-operative congenital cataract infants to reestablish binocular vision function.

关 键 词：压贴球镜 无晶状体眼 视功能 先天性白内障 婴幼儿 

分 类 号：R776[医药卫生—眼科]