儿童先天性白内障摘除联合人工晶状体植入术36例观察  

Clinical observation of 36 cases of pediatric congenital cataract extraction with intraocular lens implantation

作　　者：杨建华 许淑平 卢雪梅 盛芳芳 

机构地区：[1]江苏省苏州市吴中区越溪卫生院眼科,江苏苏州215104 [2]江苏省昆山市东方医院眼科,江苏昆山215300

出　　处：《中国实用眼科杂志》2016年第4期393-396,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察应用超声乳化吸除折叠人工晶状体囊袋内植入术治疗儿童先天性白内障的临床效果。方法回顾分析2008年1月至2011年12月在昆山市东方医院眼科，通过超声乳化摘除手术治疗的36例（40只眼）儿童先天性白内障患者，其中≤6岁者（23只眼）行后囊撕囊、前段玻璃体切除，囊袋内植入折叠式人工晶状体。术后随诊8～36月，对其术后视力、并发症、手术操作等进行观察和分析。结果术后最佳矫正视力：5．0～4．9者7只眼占18．42％（7／38），4．6～4．8者23只眼占60．53％（23／38），4．0～4．5者7只眼占18．42％（7／38）。主要并发症有：术中后囊不规则撕裂，术后角膜水肿、葡萄膜炎、后囊膜混浊，未见其他并发症。结论对儿童先天性白内障行超声乳化吸除及折叠式人工晶状体囊袋内植入术，≤6岁患儿联合撕除后囊、切除前段玻璃体技术，是安全有效的手术方式，在手术方法、术后处理上与成人白内障手术区别对待，可使术后视力达到较为理想的效果。Objective To investigate the curative effects of ultrasonic phacoemulsification and foldable intraocular lens （IOL） implantation in the capsular bag. Methods Retrospective analysis was done in 36 eases （40 eyes） of pediatric congenital cataract admitted in East Hospital of Kun- shah who underwent phacoemulsification between January 2008 and December 2011. The patients （23 eyes） aged below/or 6 years old were performed posterior continuous curvilinear capsulorhexis （PCCC） with anterior vitrectomy and foldable IOL implantation. The visual situation, complications and management were analyzed after surgery. All the children were included in a postoperative fol- low-up examination from 8 to 36 months. Results The corrected visual acuity of 5.0-4.9 was achieved in 18.42% （7/38） after surgery, 4.6-4.8 in 60.53% （23/38） and 4.0-4.5 in 18.42% （7/38）. The main operative complications included intraoperative irregular tear in the posterior capsule, post- operative corneal edema, uveitis and posterior capsular opacification. Conclusions The combined op- eration of posterior continuous curvilinear capsulorhexis （PCCC） with anterior vitrectomy and fold- able IOL implantation is a safe and effective clinical method for pediatric congenital cataract. The surgical method and postoperative treatment should be different from that of adult cataract. So it can make the postoperative visual acuity achieve more ideal effect.

关 键 词：先天性白内障 人工晶状体植入 后囊连续环形撕囊 并发症 

分 类 号：R776.1[医药卫生—眼科]