后囊连续环形撕囊联合前段玻璃体切除术在先天性白内障手术中的应用  

Posterior continuous curvilinear capsulorhexis combined with anterior vitrectomy in congenital cataract

作　　者：周林[1] 邹玉平[2] 黄素英[2] 康建芳[1] 

机构地区：[1]徐州医学院附属淮安医院眼科,江苏淮安223002 [2]中山大学中山眼科中心,眼科学国家重点实验室,广东广州510060

出　　处：《眼外伤职业眼病杂志》2010年第10期746-750,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察先天性白内障手术中联合后囊连续环形撕囊及前段玻璃体切除术的意义。方法 50例(79眼)年龄2月～8岁先天性白内障施行摘出手术(超过2岁者植入人工晶状体)。其中21例(31眼)联合后囊连续环形撕囊(Ⅰ组),29例(48眼)联合后囊连续环形撕囊及前段玻璃体切除术(Ⅱ组)。随访6～36个月,观察并比较两组视力及后囊浑浊的情况。结果术后矫正视力≥0.5者,Ⅰ组11眼(35.48%),Ⅱ组31眼(64.58%);视力0.3～0.4者,Ⅰ组14眼(45.16%),Ⅱ组14眼(29.17%);视力≤0.2者,Ⅰ组6眼(19.35%),Ⅱ组3眼(6.25%);两组比较差异有统计学意义(χ2=5.38,P<0.05)。后发性白内障(后囊浑浊≥3级者),Ⅰ组9眼(29.03%),Ⅱ组2眼(4.17%);两组比较差异有统计学意义(χ2=5.69,P<0.05)。均未出现眼底并发症。结论后囊连续环形撕囊联合前段玻璃体切除术能明显降低儿童先天性白内障术后后发障的发生率。Objective To observe effect of phacoemulsification combined with posterior continuous curvilinear capsulorhexis（PCCC） or with anterior vitrectomy（AV） in treatment of congenital cataract.Methods 79 eyes of 50 patients between 2 months to 8 years old with congenital cataracts were performed phacoemulsification,of which implanted with posterior chamber intraocular lens（IOL） beyond 2 years old.PCCC was done in 31 eyes of 21 persons（GroupⅠ） ;PCCC and AV were performed in 48 eyes of 29 persons（Group Ⅱ）.The visual axis opacification and various complications were followed up for 6-36 months.Results 11 eyes in group Ⅰ（35.48%） and 31 eyes in group Ⅱ（64.58%） get BCVA better than 0.5 post-operatively.14 eyes in group Ⅰ（45.16%） and 14 eyes in group Ⅱ（29.17%） get BCVA between 0.3 and 0.4.6 eyes in group Ⅰ（19.35%） and 3 in group Ⅱ（6.25%） get BCVA lower than 0.2.There was statistical significance（χ^2 = 5.38,P 〈0.05）.In 2 eyes（4.17%）,the posterior capsule were found opacified severe than grade 3 in group Ⅱ,while 9 eyes（29.03 %） were found in group I.Statistical significance was found between the groups（χ^2 = 5.69,P 〈0.05）.No vitreous and retinal complications was found.Conclusion Phacoemulsification combined with PCCC and AV in treatment of congenital cataract is safe and effective.It can reduce the occurance of posterior capsular opacification（PCO） obviously.

关 键 词：白内障 先天性 后囊连续环形撕囊 玻璃体切除 前段 

分 类 号：R779.66[医药卫生—眼科]