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| 基于超声生物显微镜图像分型的先天性白内障摘出术后后发性白内障的手术设计及疗效观察 | |
| 引用本文： | 谌文思,项道满. 基于超声生物显微镜图像分型的先天性白内障摘出术后后发性白内障的手术设计及疗效观察[J]. 眼科新进展, 2019, 0(11): 1063-1066. DOI: 10.13389/j.cnki.rao.2019.0244 |
| 作者姓名： | 谌文思 项道满 |
| 作者单位： | 510623 广东省广州市，广州医科大学附属广州市妇女儿童医疗中心眼科 |
| 摘 要： | 目的 基于超声生物显微镜（ultrasound biomicroscope，UBM）对先天性白内障摘出术后后发性白内障（posterior capsular opacification，PCO）图像特征的影像学分类，探讨PCO类型与手术方式选择的关系。方法 对在广州市妇女儿童医疗中心行先天性白内障摘出术，术后采用水囊式UBM成像技术进行检查，并确诊为PCO的27例（40眼）患儿的UBM检查结果进行分析。根据UBM图像特征将PCO分为3组，并根据分型实施不同的手术方式:膜性纤维化型组采用Nd:YAG激光晶状体后囊膜切开术，皮质再生型组采用前段玻璃体切割术，混合型组采用前段玻璃体切割联合电子撕囊术。术后定期随访并复查UBM。结果 全部术眼术中视轴区混浊均被清除，晶状体后囊膜中央切口均为直径3.0~4.0 mm的圆形透明区，PCO手术的成功率为100%。术后随访6~30个月，膜性纤维化型组20眼中2眼发生虹膜粘连、瞳孔膜样闭锁，再次手术，采用虹膜后粘连分离联合前段玻璃体切割术治疗，术后未再次复发；皮质再生型组14眼和混合型组6眼术后视轴区均未再次出现混浊。PCO术后总复发率为5.0%。结论 对先天性白内障摘出术后PCO的UBM图像进行分型，有助于最佳手术方式的选择，可达到更好的治疗效果。 |
| 关 键 词： | 超声生物显微镜 先天性白内障 后发性白内障 Nd:YAG激光 玻璃体切割术 |
Surgical design and effect of posterior capsule opacification after extraction of congenital cataract based on ultrasound biomicroscopy image classification |
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| CHEN Wen-Si,XIANG Dao-Man. Surgical design and effect of posterior capsule opacification after extraction of congenital cataract based on ultrasound biomicroscopy image classification[J]. Recent Advances in Ophthalmology, 2019, 0(11): 1063-1066. DOI: 10.13389/j.cnki.rao.2019.0244 | |
| Authors: | CHEN Wen-Si XIANG Dao-Man |
| Affiliation: | Department of Pediatric Ophthalmology，Guangzhou Women and Children’s Medical Center，Guangzhou Medical University，Guangzhou 510623，Guangdong Province，China |
| Abstract: | Objective To explore the relationship between the types of posterior capsule opacification (PCO) and the surgical methods based on ultrasound biomicroscope (UBM) image classification of PCO.Methods The imaging results of UBM in 27 patients (40 eyes),who were diagnosed with PCO examined by high-resolution bag/balloon UBM technique after undergoing congenital cataract extraction in Guangzhou Women and Children’s Medical Center,were analyzed.These patients were divided into three groups according to UBM image characteristics,and different operation methods were carried out according to the classification:Nd:YAG laser posterior capsulotomy was used in the membrane fibrosis group,anterior vitrectomy was used in the cortex regeneration group,and anterior vitrectomy was used in the mixed group.UBM was regularly performed during followed up.Results The opacity of the visual axis was cleared during operation.The central incision of posterior capsule of lens was a round transparent area with a diameter of 3.0-4.0 mm.The success rate of PCO is 100%.After 6-30 months of follow-up,2 eyes in the membrane fibrosis group had iris adhesion and mydriatic atresia,and then they underwent iris adhesion separation combined with anterior vitrectomy,without recurrence.No any haze occurred in 14 eyes of the cortex regeneration group and 6 eyes of the mixed type group.The total recurrence rate of PCO was 5.0%.Conclusion The classification of PCO images after congenital cataract extraction is helpful to choose the best surgical method and can achieve better therapeutic effect. |
| Keywords: | ultrasound biomicroscopy congenital cataract posterior capsule opacification Nd:YAG laser vitrectomy |
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