儿童先天性白内障改良术式探讨

目的探讨儿童先天性白内障患者常规白内障手术加后囊连续环形撕囊术与联合行后囊连续环形撕囊术加前段玻璃体切除术的疗效与并发症．方法分析我院先天性白内障患儿126例（232眼），年龄1～8岁，采用白内障针吸术联合后囊连续环形撕囊术126眼，白内障针吸术联合行后囊连续环形撕囊术加前段玻璃体切除术126眼，观察术后1a视力、并发症及眼部变化情况．结果行白内障针吸术联合行后囊连续环形撕囊术126眼中38只眼发生后发障（32．5％），行白内障针吸术联合行后囊连续环形撕囊术加前段玻璃体切除术126只眼中3只眼发生后发障（2．1％），两组比较，差异有统计学意义（P〈0．001）．结论对1～8岁儿童先天性白内障患者行白内障针吸术联合后囊连续环形撕囊术加前段玻璃体切除术较单纯行白内障针吸术联合后囊连续环形撕囊术能更有效地防止后发障的产生．

Modified Operation on Children with Congenital Cataract

Objective To evaluate the treatment effect and complication of the operation used the posterior continuous eurvilinear capsulorhexis （PCCC） with or without anterior vitrectomy （AV） in congenital cataract. Methods 126 children （232 eyes） with congenital cataract, age between 1 - 8 years, were divided into two groups： each group included 126 eyes. In the operation, every cataract eye underwent the cataract extraction with posterior continuous curvilinear capsulorhexis. In the second group, we used the anterior vitrectomy in addition. Vision acuity and complications were recorded for one year. Results 38 eyes occured posterior capsule opaeification （PCO） （32.5%） in the first group, while only 3 eyes occurred posterior capsule opacification （2.1%） in the second group. There was significant difference between two groups （P 〈 0.001 ）. Conclusions It is better to use anterior vitrectomy in the cataract surgery in the congenital children between one to eight years old. The modified operation can prevent posterior capsule opacification effectly.