两种不同手术方式治疗婴幼儿先天性白内障的比较  

Comparison of two different surgical methods to treat congenital cataract in infants

作　　者：郁佳[1] 秦梅[1] 王剑锋[1] 高自清[1] 李宁[1] 杨洪霞[1] 

机构地区：[1]蚌埠医学院第一附属医院眼科,233004

出　　处：《临床眼科杂志》2014年第1期38-40,共3页Journal of Clinical Ophthalmology

摘　　要：目的比较两种不同手术方式治疗婴幼儿先天性自内障的临床疗效。方法回顾性分析婴幼儿先天性白内障26例（41只眼），按手术方式分为A、B两组。A组11例（20只眼），应用20G玻璃体切除仪行自内障切除吸除联合前部玻璃体切除术。B组15例（21只眼），应用常规超声乳化注吸头吸除白内障联合前部玻璃体切除术。对比研究两种不同术式术中前房稳定性、虹膜脱出率、术后葡萄膜炎反应，后发性白内障等并发症发生的差异。结果A组术中前房稳定，眼压稳定，无明显虹膜脱出。B组术中前房密闭欠佳，有7只眼（33．3％）虹膜脱出。术后随访3～12个月。B组1只眼（4．8％）发生浅前房，4只眼（19．0％）出现前房渗出反应，A组均未出现。B组3只眼（14．3％）发生后发性白内障。A组术眼前、后囊环形切除孔居中，直径理想，随访期视轴区透明。两组均无继发性青光眼、视网膜脱离等并发症发生。结论应用玻璃体切割仪治疗婴幼儿先天性白内障是一种更加安全有效的手术方式。Objective To compare the effects of two different surgical methods for the treatment of congenital cata- ract. Methods This study was a retrospective analysis. Twenty-six cases （41 eyes）were divided into two groups. In group A, the lens incision and anterior vitrectomy were performed with 20-gauge vitrectomy system in 20 eyes of 11 cases. In group B, routine phacoemulsiflcafion for cataract was performed jointly with anterior vitrectomy in 21 eyes of 15 cases. We investigated the stability of anterior chamber, the rate of iris prolapse, uveitis, posterior capsule opacification and other complications in two groups. Results In group A, it was easy to maintain stable IOP （ intraocular pressure ）, and iris pro- lapse didn＇t occur during the operation. While in group B, it was difficult to maintain stable IOP, and iris prolapse oc- curred in 7 eyes （33.3% ）. All patients were followed up for 3 months to 12 months. Shallow anterior chamber and anterior chamber fibrin exudation were not found in group A during the follow-up, but in group B shallow anterior chamber was found in 1 eye （ 4.8% ） and anterior chamber fibrin exudation was found in 4 eyes（ 19.0% ） respectively. The rate of pos- terior capsule opaeifieatiun was 14.3% in group B. In group A, all of the eyes had anterior and posterior capsule center ring with ideal diameters. During the follow-up period, optic axis was clear. Other complications, such as retinal detachment, secondary glaucoma did not occur. Conclusion Vitrectomy is a safer and more effective procedure to treat congenital cata- ract.

关 键 词：超声乳化吸出术 晶状体切割吸除 前部玻璃体切除术 先天性白内障 婴幼儿 

分 类 号：R779.6[医药卫生—眼科]