儿童人工晶状体二期植入术

目的探讨人工晶状体（IOL）二期植入术矫正儿童无晶状体眼的疗效和手术适应证。方法对37例（57眼）后囊和悬韧带完整或仅中央区后囊缺损的儿童无晶状体眼，二期植入人工晶状体，术后随访3～54个月。结果术后裸眼视力均等于或高于术前矫正视力，其中术后裸眼视力≥0．5者30眼（52．63％），术后矫正视力≥0．5者45眼（78．95％）。并发症包括虹膜后粘连9眼（15．79％），前房渗出物7眼（12．28％），人工品状体偏位2眼（3．51％）。结论对于尚存完整或部分后囊支撑的无晶状体眼进行前后囊软性分离，注吸周边增生的皮质，虹膜粘连分离，后囊切开，前段玻璃体切除，再植入人工晶状体，可改善患儿视功能。

Secondary intraocular lens implantation in children

Objective To investigate the effectiveness and indication of secondary intraocular lens （IOL） implantation in the management of pediatric aphakia. Methods The intraocular lens were implanted secondarily in 57 aphakia eyes of 37 children with intact posterior capsule and zounles or capsule rupture at central zone. The postoperative visual acuity change and surgical complications were followed up for 3 - 54 months. Results During the follow-up period, all of the eyes achieved postoperative uncorrected visual acuities equal or better than the corrected visual acuities before the operation. The postoperative uncorrected visual acuities was no less than 0. 5 in 30 eyes （52. 63% ） and the corrected visual acuitues in 45 eyes （78.95%）. Complications included the posterior synechia of the iris in 9 eyes （ 15. 79% ）, exudation in anterior chamber in 7 eyes （12. 28% ）, IOL decentration in 2 eyes （3.51% ）. Conclusion Secondary intraocular lens implantation after soft separation of anterior and posterior capsule, removing periphery cortex, separation of synechia, cutting of posterior capsule and anterior vitrectomy, would improve the visual function of pediatric aphakia patient.