儿童白内障三种术式后发障形成的临床探讨  

Clinical study of three different cataract surgeries on after-cataract in children.

作　　者：朱格非[1] 黄菊天[1] 徐锦堂[2] 葛钧[1] 罗小玲[1] 

机构地区：[1]暨南大学医学院附属二院深圳市人民医院眼科,518020 [2]暨南大学医学院眼科研究室

出　　处：《眼外伤职业眼病杂志》2003年第4期249-251,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的 探讨预防儿童后发性白内障的手术方式。方法 48例(57眼)儿童白内障,其中先天性白内障41眼,外伤性白内障16眼,年龄3～14岁。57眼随机分为3组,每组都行小切口、前囊连续环形撕囊,白内障吸出及折叠式人工晶状体植入。Ⅰ组行后囊抛光,保留完整后囊;Ⅱ组行后囊连续环形撕囊;Ⅲ组行后囊连续环形撕囊及前部玻璃体切除术。术后随访3～18月,平均12月,观察并记录各组后发性白内障发生情况及其它并发症。结果 后发障≥3级者发生率Ⅰ组为42%,Ⅱ组为21%,Ⅲ组为0。各组均无玻璃体疝、视网膜脱离或囊样黄斑水肿等并发症发生。术后矫正视力≥0.5者40眼(70%),0.1～0.4者11眼(19%)。结论 白内障吸出及折叠式人工晶状体植入术中,行后囊连续环形撕囊联合前部玻璃体切除术可有效地预防儿童后发性白内障的发生,远期效果需进一步观察。Objective To evaluate the surgical method which can efficiently prevent the occurrence of after cataract in children. Methods 48 chil-dren(57 eyes) with cataract,aged 3 - 14 years (mena 7 years),including 41 eyes of congenital cataract and 16 eyes of traumatic cataract.57 eyes were randomly divided into 3 groups. GroupⅠwas treated with phacoery-sis and foldable IOL implantation; group Ⅱ with posterior continuous curvilinear capsulorhexis ( PCCC) and foldable IOL implantation; group Ⅲ with PCCC and anterior vitrectomy and foldable IOL implantaion. Postoperative, the visual acuity, after cataract and other complications were followed up for 12 months ( range 3 - 18 months ) . Results The best corrected visual acuity after the operation:40 eyes≥0.5(70% ) , 11 eyes 0.1 -0.4(19%) .The rate of occurrence of after cataract was 42% in the group Ⅰ,21% in the group Ⅱ and 0% in the group Ⅲ .All there was no post-operative complication, such as retinal detachment, cystoid macu-lar edema, etc. in all surgical eyes. Conclusion Phacoerysis combined with PCCC and anterior vitrectomy and foldable 10L implantation is a safe cataract surgical method which can effectively prevent the formation of after cataract in children.

关 键 词：白内障 外科手术 手术方式 儿童 后发性白内障 后囊环形撕囊 玻璃体切除 

分 类 号：R779.66[医药卫生—眼科]