单眼先天性白内障患儿术后无晶状体眼采用不同矫正方式的视功能及眼部并发症评估  

Evaluation of visual function and adverse effects of different correction methods in the infants with monocular aphakia after congenital cataract surgery

作　　者：陈珺珏 孙平 韦严[1] 亢晓丽[1] CHEN Jun-jue;SUN Ping;WEI Yan;KANG Xiao-li(Department of Ophthalmology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Ophthalmology,Eye&Ent Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]上海交通大学医学院附属新华医院眼科,上海200092 [2]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《上海交通大学学报（医学版）》2018年第10期1208-1211,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生和计划生育委员会重点项目(201440037)~~

摘　　要：目的·分析单眼先天性白内障患儿术后无晶状体眼佩戴硬性透气性角膜接触镜(rigid gas permeable contact len,RGPCL)及一期植入人工晶状体(intraocular len,IOL)患儿的视功能及眼部相关并发症。方法·回顾性分析了单眼先天性白内障患儿术后无晶状体眼佩戴RGPCL及一期植入IOL患儿的视力、眼位、眼球震颤、遮盖依从性和角膜接触镜相关并发症及不良事件。结果·共60例患者入组。组1为单眼无晶状体眼患儿佩戴RGPCL 20例,组2为单眼先天性白内障一期植入IOL患者40例。组1患者的视力、眼位均显著改善(均P<0.05),组1及组2患者终末视力和终末眼位差异无统计学意义,组1的眼球震颤缓解率高于组2。遮盖健眼依从性好的患者较依从性差的患者术后视力恢复更好(P<0.05)。组1患者未出现影响视力的眼部病理改变,组2患者较组1患者出现更多的眼部并发症。结论·佩戴RGPCL是一种对于单眼白内障术后无晶状体眼的安全、有效的光学矫正方式,尤其对2岁以下不适宜植入IOL的患者,可与一期植入IOL达到相似的矫正效果,且较少出现眼部并发症。Objective·To analyze the changes in visual function and adverse effects of wearing rigid gas permeable contact lens(RGPCL)and primary intraocular lens(IOL)implantation in the infants with monocular aphakia after congenital cataract surgery.Methods·The pre-and postoperative visual acuity,strabismus,nystagmus,adherence to patching and adverse events of the patients with unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation were analyzed retrospectively.RGPCLs were used to correct aphakia who did not receive IOLs.Results·All of 60 patients were included in this study.Twenty patients with unilateral aphakia used RGPCLs(group 1).Forty patients were implanted with IOLs primarily(group 2).In group 1,there was obvious improvement in visual acuity and strabismus(P<0.05).There was no statistic difference in visual acuity and strabismus between group 1 and group 2 finally.Nystagmus remission rate in group 1 was higher than that in group 2.The patients with adherence to patching had better visual acuity after operation than those without(P<0.05).All of the patients in group 1 had no ocular disease that affect visual acuity.More adverse events happened in group 2.Conclusion·Wearing RGPCL is a safe and effective optical correction method for the patients with monocular aphakia after congenital cataract surgery,especially for the patients below 2 years old who are not suitable for IOL implantation.RGPCL has similar visual correction effect on the patients with primary IOL implantation,but it is accompanied by less adverse events.

关 键 词：硬性透气性角膜接触镜 先天性白内障 单眼 无晶状体 人工晶状体 

分 类 号：R779.7[医药卫生—眼科]