前段玻璃体切割在儿童白内障手术中的必要性  

Necessity of anterior vitrectomy in pediatric cataract surgery

作　　者：徐永红[1] 邢怡桥[1] 江双红[1] 

机构地区：[1]武汉大学人民医院眼科,湖北省武汉市430060

出　　处：《眼科新进展》2010年第7期667-669,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨儿童白内障手术联合前段玻璃体切割的必要性。方法对41例(63眼)2～12岁儿童白内障患者行白内障吸除、前后囊环形撕除,依是否联合切除前段玻璃体分为非联合组20例(31眼)及联合组21例(32眼),均植入丙烯酸酯Acrysof折叠式人工晶状体(intraocular lens,IOL)。随访14～36个月。观察记录2组患者术后视力、后发性白内障及其他并发症。结果术后视力≥0.3者,联合组与非联合组分别为23眼与19眼,2组间差异无统计学意义(P>0.05);而分别有3眼(9.4%)和11眼(35.5%)发生后发性白内障,差异有统计学意义(P<0.05)。≤7岁儿童后发性白内障发生率2组分别为12.5%(2眼)和53.3%(8眼),差异有统计学意义(P<0.05);而>7岁者则组间差异无统计学意义(P>0.05)。2组各有2眼发生虹膜后粘连,各有1眼发生IOL轻度偏中心现象。结论 7岁以下儿童白内障吸除术中,联合前段玻璃体切割能显著减少后发性白内障发生,7岁以上儿童则并非必需。Objective To discuss the necessity of anterior vitrectomy in pediatric cataract surgery.Methods Forty-one pediatric cataract patients （63 eyes） aged from 2 years old to 12 years old received the cataract surgery,were assigned randomly to two groups,no anterior vitrectomy group（20 cases,31eyes）and anterior vitrectomy group（21 cases,32 eyes）.All eyes had anterior and posterior continuous curvilinear capsulorhexis,the Acrysof intraocular lens （IOL） were implanted into all eyes.The visual acuity,incidence of after-cataract and other complications were recorded and followed-up from 14 months to 36 months.Results The visual acuity was 0.3 or better in 23 eyes in anterior vitrectomy group and 19 eyes in no anterior vitrectomy group,there was no statistical difference（P0.05）.The after-cataract appeared in 3 eyes （9.4%） in vitrectomy group and 11 eyes （35.5%） in no vitrectomy group,there was statistical difference（P0.05）.Children aged 7 years old or younger with after-cataract were 2 eyes （12.5%） in vitrectomy group,which was less than that in no vitrectomy group（8 eyes,53.3%）,there was statistical difference（P0.05）.but in children older than 7 years old there was no statistical difference（P0.05）.The posterior synechias were observed respectively in 2 eyes in two groups,and 1 eye in two groups respectively developed IOL mild decentration postoperatively.Conclusion In cataract surgery of children younger than 7 years old,the anterior vitrectomy can decrease the occurrence of after-cataract obviously,but the anterior vitrectomy is not necessary in children older than 7 years old.

关 键 词：白内障摘出术 人工晶状体 儿童 前段玻璃体切割 

分 类 号：R776.1[医药卫生—眼科]