25G玻璃体切割手术系统经角膜切口治疗先天性白内障的疗效分析  

Effect of congenital cataract treated by 25-gauge vitrectomy system via corneal incision in infants

作　　者：张磊 甄静 朴荷妮 李情情 叶子隆 

机构地区：[1]北京美尔目医院,100036

出　　处：《中国斜视与小儿眼科杂志》2017年第1期13-16,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的探讨25G玻璃体切割手术系统经角膜切口治疗婴儿先天性白内障的效果及安全性。方法回顾性分析15例(30只眼)使用25G玻璃体切割手术系统经角膜切口行前囊环形切除、晶状体切除、后囊环形切除、前部玻璃体切除术治疗婴儿先天性白内障的临床资料,观察手术时间、切口闭合情况、术中及术后并发症。手术后随访时间3个月及以上。结果手术时间8.13±1.47(范围:5.38-11.75)分钟,手术结束时切口闭合好,无需缝合,无术中并发症。1眼因晶体核硬改为超声乳化晶体吸除,其余29眼均由25G玻璃体切割手术系统完成手术。2眼(6.7%)术后一过性眼压升高,药物控制并停药后眼压正常。随访时平均眼压与术前平均眼压相比差异无统计学意义。所有患儿术后前房形成好,前房反应轻微。2眼(6.7%)瞳孔点状部分后粘连,其余患者无后粘连。2眼(6.7%)因中央视轴区混浊发生再次手术。结论 25G玻璃体切割手术系统经角膜切口行晶状体切除联合前部玻璃体切割术治疗婴儿先天性白内障具有良好临床效果。Objective To evaluate the effect and safety of treatment of congenital cataract by 25-gauge vitrectomy system via corneal incisionl in infants. Methods This is a retrospective study. We collected 15 cases （30 eyes） of congenital cataract performed with anterior vitrectorhexis, lensectomy, posterior vitrectorhexis and anterior vitrectomy using 25-gauge vitrectomy system via corneal incision. The duration of operation, closeness of the corneal incision, intraoperative and postoperative complications were analyzed. All the patients were followed up for at least 3 months. Results The average duration of operation was 8.13＋1A7 （5.38-11.75） minutes, there was no wound leakage and no suture needed, no intraoperative com- plications were observed. Surgery in 29 eyes out of the 30 eyes was completed with the 25-gauge system alone. One eye was converted to the phacoemulsification because of the hard nucleus. 2 eyes （6.7%） experienced transient elevated IOP postop- eratively, all others＇ IOP was normal at day 1 postoperatively. The anterior chamber was well formed and inflammatory reaction was mild. The pupil was a perfect circular shape except focal pupil iris adhesions occurred in 2 eyes （6.7%）. 2 eyes （6.7%） developed visual axis pacification and were reoperated. Conclusions 25-gauge vitrectomy system via corneal incision appears effective and safe for the treatment of congenital cataract in infants.

关 键 词：先天性白内障 25G玻璃体切割手术系统 角膜切口 

分 类 号：R779.6[医药卫生—眼科]