儿童人工晶状体固定性瞳孔夹持的原因和手术复位  

The causes and reposition of fixed intraocular lens pupillary capture in children

作　　者：吴明星[1] 刘奕志[1] 刘玉华[1] 程冰[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中华眼科杂志》2004年第3期190-192,共3页Chinese Journal of Ophthalmology

摘　　要：目的　分析儿童白内障摘除术后人工晶状体 (IOL)固定性瞳孔夹持的原因 ,并探讨有效的处理方法。方法　收集年龄 <14岁、白内障摘除后房型IOL植入术后发生固定性瞳孔夹持患者 30例 (31只眼 )的临床资料 ,分析其发生原因和并发症 ,并对其中 8例 (8只眼 )合并严重并发症患者行IOL复位手术。结果　全部患者均发生较严重的葡萄膜炎性反应及其所致的虹膜后粘连和瞳孔膜闭或闭锁 ,以及不同程度的后发性白内障。IOL复位手术中可见 8例患者均发生不同程度的晶状体周边皮质再生。结论　白内障摘除术后葡萄膜炎性反应、晶状体皮质再生及后发性白内障是引起儿童IOL固定性瞳孔夹持的主要原因。手术分离虹膜粘连、清除晶状体再生皮质并切除后发性白内障 ,可有效复位IOL。Objective To analyze the cause of fixed intraocular lens (IOLs) pupillary capture in children and investigate the rational methods to reposit intraocular lens. Methods Thirty-one eyes (30 cases) with fixed intraocular lens pupillary capture under 14 years old were analyzed based on clinical data; the causes and the complications were also evaluated. The IOL reposition procedure was performed in 8 cases (8 eyes) with severe complications. Results Different extent of secondary cataract, posterior iris synechia caused by severe postoperative uveal tract reaction were existed in all 30 cases, corecleisis was occurred in some severe cases. During reposition operation, different extent of lens cortex regeneration in the equator portion of capsule bag was found in all eight cases. Conclusion Fixed pupillary capture of IOL is the common complication in children after cataract surgery. Severe postoperative uveal tract reaction and secondary cataract and lens cortex regeneration are the major causes of intraocular lens pupillary capture. The intraocular lens could be reposited through iris synechia separation, regenerated lens cortex cleaning and secondary cataract extraction.

关 键 词：儿童 人工晶状体植入 定性瞳孔夹持 原因 手术复位 术后并发症 白内障 摘除术 

分 类 号：R779.66[医药卫生—眼科]