玻璃体切割头前囊膜环形切除术在先天性白内障患儿中的应用  

Application of anterior capsulectomy with vitreous tip in congenital cataract surgery

作　　者：董宏伟[1,2] 

机构地区：[1]邢台市眼科医院 [2]河北省眼病治疗中心,河北省邢台市054001

出　　处：《眼科新进展》2011年第1期62-63,67,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨玻璃体切割头前囊膜环形切除术在婴幼儿先天性白内障患儿中的应用。方法收集2004年11月至2008年10月在我院就诊的1～2岁先天性白内障患儿50例(60眼),随机分为环切组和撕囊组,环切组26例(32眼),撕囊组24例(28眼)。环切组应用玻璃体切割头环形切除前囊膜形成前囊孔,撕囊组行前囊膜连续环形撕囊术。2组患者术眼均行超声乳化晶状体吸出、后囊膜连续环形撕囊、前部玻璃体切割及折叠人工晶状体植入术。观察2组前囊膜切开手术时间、术中及术后并发症等情况。结果环切组术中均形成位置居中、边缘整齐、直径约5mm的理想前囊孔。撕囊组术中前囊放射状撕裂9眼(32.14%),前囊孔直径偏大或明显偏中心12眼(42.85%);2组比较差异有统计学意义(P<0.05);人工晶状体虹膜夹持7眼(25.00%)均出现在撕囊组前囊膜放射状撕裂和前囊孔直径偏大患儿中,环切组无一例发生人工晶状体移位,差异有统计学意义(P<0.05);环切组前囊膜切开平均时间为(5.21±0.12)min,撕囊组为(1.71±0.25)min,2组比较差异有统计学意义(P<0.05)。结论玻璃体切割头前囊膜环形切除术可形成理想的前囊孔,是手法连续环形撕囊术的有效替代方法,适合在先天性超声乳化晶状体吸出术中应用。Objective To evaluate the application of anterior capsulectomy with vitreous tip in total congenital cataract surgery.Methods Sixty eyes（50 cases）with congenital cataracts from November 2004 to October 2008 in our hospital were randomly divided into two groups,group A received anterior capsulectomy with vitreous tip（26 cases,32 eyes）,group B received anterior continuous curvilinear capsulorhexis（24 cases,28 eyes）.Patients in both two groups were taken lens cortex aspiration,anterior vitrectomy and intraocular lens implantation.The operation time and complications in and after operation were observed between two groups.Results All eyes in group A had smooth round anterior capsulectomy,the ideal anterior capsular hole was in middle and orderly with 5 mm diameter,but 9 eyes（32.14%）occurred radial tears and 12 eyes（42.85%）had too large capsulorhexis in group B,there was statistical difference between two groups（P0.05）;About 7 eyes（25.00%）with pupil caplture of intraocular lens appeared in group B,all happened in cases of radial tears and too large capsulorhexis,none in group A,the difference between two groups was significant（P0.05）;The mean time on anterior capsulectomy in group A was（5.21±0.12）min,and group B was（1.71±0.25）min,there was statistical difference between two groups（P0.05）.Conclusions Anterior capsulectomy completed by vitreous tip can receive smooth round anterior capsular hole.It is a useful substitution to manual continuous curvilinear capsulorhexis in children,especially for congenital cataract surgery.

关 键 词：玻璃体切割头 环形切除术 先天性白内障 

分 类 号：R779.6[医药卫生—眼科]