婴幼儿先天性白内障术中应用玻璃体切除器的效果  

Efficacy of application of vitrectomy unit for infantile congenital cataract

作　　者：金波[1] 郭菊 周朋义[1] 谢坤鹏[1] 金学民[1] Jin Bo;Guo Ju;Zhou Pengyi;Xie Kunpeng;Jin Xuemin(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2021年第8期595-599,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金(81800832)。

摘　　要：目的:评价婴幼儿先天性白内障术中应用玻璃体切除器的效果。方法:回顾性研究。纳入郑州大学第一附属医院2016年10月至2020年10月2岁以下一期手术不植入人工晶状体的先天性白内障40例(64眼),根据手术方式分为两组:观察组22例(34只眼),接受23 G玻璃体切除器经角膜缘切口晶状体切除联合前段玻璃体切除术,并前房内留置适量的黏弹剂;对照组18例(30眼)先以超声乳化器吸出晶状体再进行前段玻璃体切除术。术后随访1年,比较两组术中有无囊撕裂、切口缝合率、手术耗时及并发症。结果:术中前囊撕裂率观察组为0,低于对照组的26.7%( χ^(2)=10.362, P=0.001);切口缝合率观察组为23.5%,低于对照组的100.0%( χ^(2)=38.638, P<0.001);手术耗时观察组为(15.27±0.32)min,低于对照组的(18.94±0.40)min( t=-7.175, P<0.001);术后1 d低眼压率观察组为0,低于对照组的26.7%( χ^(2)=10.362, P=0.001)。 结论:2岁以下婴幼儿先天性白内障一期不植入人工晶状体以玻璃体切除器进行手术安全有效。Objective To observe the efficacy of application of vitrectomy unit in the treatment of infantile congenital cataract.Methods This was a retrospective study.Sixty-four eyes of 40 cases of infantile congenital cataract under 2 years old without intraocular lens implantation in the first surgery from Oct.2016 to Oct.2020 in the First Affiliated Hospital of Zhengzhou University were divided into two groups according to the operation method.The observation group with 34 eyes of 22 cases underwent lensectomy combined with anterior vitrectomy using 23-gauge vitreous cutting system without intraocular lens implantation,and filling in moderate amount of viscoelastic agent through the corneal limbal incision.The control group with 30 eyes of 18 cases recieved phacoemulsification combined with anterior vitrectomy.All patients were followed up for 1 year after operation.The intraoperative capsular tear,the incision suture rate,the operation time and complications between the two groups were compared.Results The tear rate of anterior capsule during in the observation group was 0,which was lower than the 26.7%in the control group(χ^(2)=10.362,P=0.001).The incision suture rate of the observation group was 23.5%,which was lower than the 100%of the control group(χ^(2)=38.638,P<0.001).The operation time in the observation group was(15.27±0.32)min,which was lower than the(18.94±0.40)min in the control group(t=-7.175,P<0.001).At 1 day after operation,the rate of low IOP in the observation group was 0,which was lower than the 26.7%in the control group(χ^(2)=10.362,P=0.001).Conclusion It is safe and effective to apply vitrectomy unit in the treatment of infantile congenital cataract,especially for patients under 2 years old without primary IOL implantation.

关 键 词：白内障 先天性 婴幼儿 玻璃体切除器 23G 25G 

分 类 号：R779.66[医药卫生—眼科]