双撕囊联合前部玻璃体切除治疗儿童先天性白内障

目的:观察双撕囊联合前部玻璃体切除治疗先天性白内障的疗效。方法:对31例52眼2月龄～12岁先天性白内障患儿实行白内障囊外摘除、后囊连续环形撕囊、前部玻璃体切除术,联合Ⅰ期或Ⅱ期IOL植入,平均随访16mo。结果:31例患儿之中有27例44眼术后能检查视力,最佳矫正视力>0.5者23眼,>0.3者12眼,<0.3者9眼,另外,<2岁的患儿4例8眼无法进行视力表检查,但相对术前跟随光亮或有注视目标的能力有所提高。术后并发症:后发性白内障3眼、葡萄膜炎7眼、角膜水肿5眼,人工晶状体偏位、黄斑囊样水肿、视网膜脱离等严重并发症尚未出现。结论:双撕囊联合前部玻璃体切除术联合IOL植入能预防后发性白内障等并发症的发生,是比较安全有效的治疗儿童先天性白内障的手术方式。

Effect of double capsulorhexis combined with anterior vitrectomy in congenital cataract

AIM:To study the effect of double capsulorhexis combined with anterior vitrectomy(AV) in congenital cataract. ·METHODS:Thirty-one cases (52 eyes) (age ranging from 2 months to 12 years) underwent posterior continuous circular capsulorhexis(PCCC) and anterior vitrectomy after cataract extraction,and intraocular lens(IOL) were implanted in some eyes. The median follow-up time was 16 months. ·RESULTS:Among the 44 eyes of 27 patients who could do the visual examination,23 eyes had a corrected visual acutiy of 0.5 or better;12 eyes had a corrected visual acutiy of 0.3 or better; 9 eyes had a corrected visual acuity of 0.3 or below. 8 eyes in much younger children who could not receive visual examination had better capability of light following and visual fixation after operation. The postoperative complications included posterior capsular opacity(PCO) in 3 eyes,uveitis in 7 eyes,corneal edema in 5 eyes. Some severe complications such as off-centre IOL,cystoid macular edema and retinal detachment did not occur. ·CONCLUSION:The double capsulorhexis combined with anterior vitrectomy and IOL implanted into eye seems to be an safe and effective method to prohibit after-cataract in the congenital cataract extractions.