儿童白内障人工晶状体囊夹持植入术

目的评价儿童白内障人工晶状体后囊夹持植入术的临床效果。方法对儿童白内障43例（52眼）施行前后囊环形撕囊联合前部玻璃体切除及人工晶状体后囊夹持术。术后观察视力,人工晶状体的位置,后发性白内障,瞳孔夹持等并发症。术后随访1～48个月,平均23个月。结果术后矫正视力〉0.5者占57.7%,人工晶状体位置稳定。后发性白内障1眼,视力0.5。无瞳孔夹持、视网膜脱离或黄斑水肿等并发症发生。结论儿童白内障采用前后囊环形撕囊联合前部玻璃体切除及后囊夹持术效果良好。     

先天性白内障手术中后囊撕囊联合人工晶状体后囊嵌顿术的应用

目的探讨先天性白内障手术中后囊撕囊联合人工晶状体后囊嵌顿术的应用效果。方法对32例(36只眼)先天性白内障,手术中采用后囊连续环形撕囊联合人工晶状体光学区后囊口嵌顿术,术后随访24个月以上。结果 36只眼均将人工晶状体攀植入囊袋,光学区嵌顿于后囊口。术后矫正视力较术前均有提高,其中最佳矫正视力≥0.3者33只眼(91.7%),≥0.5者22只眼(61.1%)。后囊中央部混浊0级者27只眼(75.0%),1级者4只眼(11.1%),2级者3只眼(8.3%),3级者2只眼(5.6%),未出现4级混浊的病例。无眼底并发症。结论先天性白内障术中,行后囊环形撕囊联合人工晶状体光学区后囊嵌顿术,能有效阻止中央部后囊混浊的发生,有助于视功能的恢复。     

儿童白内障Ⅰ期后囊连续环形撕囊临床观察

目的：探讨Ⅰ期后囊连续环形撕囊对儿童后发障的预防作用。方法：对42例（48只眼）在植入人工晶状体前施行Ⅰ期后囊连续环形撕囊，术后随访2个月至2年。结果：术后矫正视力≥0．5者有21只眼，占48．3％，随访期间有40只眼（83．3％）保持中央视轴区透明或基本透明。术后未发现严重并发症。结论：儿童白内障摘除联合人工晶状体植入术中施行Ⅰ期后囊连续环形撕囊，安全有效，在一定程度上可减少后囊混浊的发生。     

后囊连续环形撕囊在防治儿童人工晶状体植入术后后囊混浊中的作用

目的 探讨后囊连续环形撕囊在预防儿童白内障人工晶状体植入术后后囊混浊中的作用。方法 对29例29眼儿童白内障在植入人工晶状体后行一期后囊环形撕囊，术后随访3个月－2a。结果 术后随访显示27眼获得视轴透明区，眼底可见，矫正视力均有不同程度的提高。结论 一期后囊连续环形撕囊是预防儿童白内障人工晶状体植入术后后囊混浊的可行方法。     

Ⅰ期后囊连续环形撕囊术在白内障术中应用

目的探讨自内障行晶状体超声乳化吸出人工晶状体植入术中Ⅰ期后囊连续环形撕囊术防治后囊浑浊的临床疗效及可行性。方法对192例（192眼）并发性白内障和术中发现后囊浑浊的老年性白内障,施行常规晶状体超声乳化吸出联合人工晶状体植入同时行后囊连续环形撕囊术。术后随访6～24月,观察视力、视轴区浑浊、人工晶状体位置、眼压、并发症等情况。结果术后矫正视力1．0以上的92眼（47．91％）、0．5～0．9者60眼（31．25％）、0．2—0．4者40眼（20．83％）。随访期间人工晶状体位置正、视轴区透明、眼压正常。并发症：4眼黄斑囊样水肿（2．08％）,无视网膜脱离等出现。结论Ⅰ期后囊连续环形撕囊术并发症少、方法简便、是防治后囊浑浊有效、经济的好方法,但需慎重选择手术适应症。     

白内障摘除联合后囊连续环形撕囊治疗先天性白内障

目的：观察先天性白内障摘除术中行后囊连续环形撕囊（PCCC）防治后发性白内障的疗效及可能出现的并发症。 方法：采用小切口先天性白内障单纯囊外摘除或联合人工晶状体植入术，对58例97眼先天性白内障患者进行后囊连续环形撕囊，使晶状体后囊中央形成约3～5mm的囊膜缺损区，行前部玻璃体切除术，以避免后发性白内障的发生。 结果：Ⅰ期植入人工晶状体50眼：术后1mo矫正视力≥0．6者18眼，0．5以下42眼；术后3mo矫正视力≥0．6者20眼，0．5以下46眼；术后6～12mo矫正视力≥0．6者21眼，0．5以下50眼。术后lmo第1次复查，无1眼发生后发性白内障，3mo周边部后囊膜浑浊40例，撕囊区清亮。6～12mo16眼发生新生膜，10眼少量玻璃体脱出于前房，玻璃体轻度浑浊，瞳孔不圆18眼，人工晶状体偏位10眼，无1眼发生视网膜脱离。 结论：后囊连续环形撕囊是一种经济、安全、高效的防止先天性白内障术后后发性白内障的手术方式，适用于不能配合激光治疗的儿童，但存在一定的复发率。     

儿童白内障后囊撕囊及人工晶状体后囊嵌顿术

目的研究儿童白内障摘出术中后囊处理方法。方法对26例(38眼)儿童白内障手术中采用后囊连续环形撕囊联合人工晶状体视区后囊嵌顿,术后随访(14±4.51)月。结果34眼后囊连续环形撕囊联合人工晶状体后囊嵌顿成功。此34眼中18眼玻璃体前界膜完整,16眼行前段玻璃体切除。经随访2眼术后3月视轴区玻璃体前界膜轻度浑浊,其余32眼视轴区保持透明。结论后囊连续环形撕囊联合人工晶状体视区后囊嵌顿是预防儿童白内障人工晶状体植入术后后囊浑浊,减少对玻璃体、视网膜干扰的可行方法。     

后囊环形撕开联合人工晶状体后囊嵌顿术治疗儿童白内障

目的 探讨连续环行撕后囊联合人工晶状体后囊嵌顿术预防儿童后发性白内障的可行性.方法 采用连续环行撕后囊联合人工晶状体后囊嵌顿术,治疗30例(49只眼)儿童先天性白内障.记录术前、术后视力及术中、术后并发症.结果 术中有44只眼连续环行撕后囊联合人工晶状体后囊嵌顿成功.随访过程中嵌顿成功患儿视轴区保持透明.结论 连续环行撕后囊联合人工晶状体后囊嵌顿术治疗儿童白内障能安全、有效地预防后发性白内障的发生.     

选择性前后囊联合环形撕囊人工晶状体植入术

目的 探讨前后囊联合环形撕囊人工晶状体植入术的技术.方法 对68例白内障施行前后囊连续环形撕囊,手法碎核并植入人工晶状体.结果 56例撕囊一次成功,10例在囊膜剪辅助下完成,2例人工晶状体前囊孔夹持.术后1周平均眼压15.31±5.6 mmHg.术后3月矫正视力≥0.5者58眼占85.3%,瞳孔区透明,无明显人工晶状体偏位或眼底异常改变.结论 前后囊联合环形撕囊植入人工晶状体,是安全有效的预防术后后囊浑浊的常规方法之一.     

儿童白内障后囊撕囊联合前玻璃体切除预防后囊浑浊

目的探讨后囊撕囊联合前段玻璃体切除术对小儿白内障术后后发障的预防。方法对58例（62眼）儿童白内障采用超声乳化后行后囊撕囊联合前段玻璃体切除,再行人工晶状体植入,术后随访2a以上。结果术后矫正视力〉0.3者59眼（95.16%）。随访显示56眼（90.32%）视轴区透明。结论后囊撕囊联合前玻璃体切除可预防儿童白内障术后后囊浑浊的发生。     

人工晶状体光学部囊袋后嵌入治疗儿童先天性白内障

目的 评价人工晶状体（IOL）囊上植入、光学部囊袋后嵌入治疗儿童白内障的临床效果。设计 回顾性病例系列。研究对象 15例（17眼）儿童先天性白内障患者。方法 超声乳化白内障吸除后，后囊连续环形撕囊，直径约4mm，将IOL光学部嵌于后囊后，襻位于囊袋上，使囊袋闭锁。主要指标裸眼视力、眼压、IOL位置及并发症。结果 术中17眼按设计的手术方式顺利完成。术后6个月5眼IOL位置从囊袋后向前移位至囊袋前，这其中有4眼发生视轴区混浊，余13眼在随访期间均未出现视轴区混浊。术后6个月的主要并发症为IOL表面沉着物：1级3眼（18％），2级7眼（41％）。虹膜前粘连1眼（6％），后粘连4眼（24％）。瞳孔变形5眼（29％）。结论 应用囊上植入、光学部囊袋后嵌入IOL治疗儿童白内障安全有效，可有效预防后发性白内障的发生。     

人工晶状体光学部囊膜后嵌顿术治疗学龄期儿童外伤性白内障术后无晶状体眼

目的 评价人工晶状体(IOL)睫状沟植入、光学部囊膜后嵌顿治疗学龄期儿童外伤性白内障术后无晶状体眼的临床效果.方法 回顾性系列病例研究.对13例(13只眼)外伤性白内障术后无晶状体眼行IOL睫状沟植入、光学部囊膜后嵌顿术患儿的临床资料进行回顾性分析,记录术前及术后的裸眼视力、最佳矫正视力、屈光度数和眼压.观察手术并发症和术后眼部情况,随访时间为6～42个月.结果 IOL睫状沟植入、光学部囊膜后嵌顿术中共13只眼囊膜后嵌顿成功;术后最佳矫正视力0.2～1.0,嵌顿成功患儿随访期间均未出现视轴区混浊,IOL位置稳定;主要并发症包括前房渗出物、虹膜后粘连、IOL表面沉积物,仅1例患儿出现IOL襻异位.结论 IOL睫状沟植入、囊膜后嵌顿治疗学龄期儿童外伤性白内障术后无晶状体眼安全有效.     

人工晶状体光学部囊膜后嵌顿术治疗学龄期儿童外伤性白内障术后无晶状体眼

目的 评价人工晶状体(IOL)睫状沟植入、光学部囊膜后嵌顿治疗学龄期儿童外伤性白内障术后无晶状体眼的临床效果.方法 回顾性系列病例研究.对13例(13只眼)外伤性白内障术后无晶状体眼行IOL睫状沟植入、光学部囊膜后嵌顿术患儿的临床资料进行回顾性分析,记录术前及术后的裸眼视力、最佳矫正视力、屈光度数和眼压.观察手术并发症和术后眼部情况,随访时间为6～42个月.结果 IOL睫状沟植入、光学部囊膜后嵌顿术中共13只眼囊膜后嵌顿成功;术后最佳矫正视力0.2～1.0,嵌顿成功患儿随访期间均未出现视轴区混浊,IOL位置稳定;主要并发症包括前房渗出物、虹膜后粘连、IOL表面沉积物,仅1例患儿出现IOL襻异位.结论 IOL睫状沟植入、囊膜后嵌顿治疗学龄期儿童外伤性白内障术后无晶状体眼安全有效.     

人工晶状体光学部囊膜后嵌顿术治疗学龄期儿童外伤性白内障术后无晶状体眼

目的 评价人工晶状体(IOL)睫状沟植入、光学部囊膜后嵌顿治疗学龄期儿童外伤性白内障术后无晶状体眼的临床效果.方法 回顾性系列病例研究.对13例(13只眼)外伤性白内障术后无晶状体眼行IOL睫状沟植入、光学部囊膜后嵌顿术患儿的临床资料进行回顾性分析,记录术前及术后的裸眼视力、最佳矫正视力、屈光度数和眼压.观察手术并发症和术后眼部情况,随访时间为6～42个月.结果 IOL睫状沟植入、光学部囊膜后嵌顿术中共13只眼囊膜后嵌顿成功;术后最佳矫正视力0.2～1.0,嵌顿成功患儿随访期间均未出现视轴区混浊,IOL位置稳定;主要并发症包括前房渗出物、虹膜后粘连、IOL表面沉积物,仅1例患儿出现IOL襻异位.结论 IOL睫状沟植入、囊膜后嵌顿治疗学龄期儿童外伤性白内障术后无晶状体眼安全有效.

Abstract：

Objective To assess the clinical effects of supracapsular implantation with optic capture of the posterior chamber intraocular lens in school-age children with traumatic cataract. Method It was a retrospective case series study. Thirteen cases ( 13 eyes) received posterior curvilinear capsulorhexis with optic capture of the posterior chamber intraocular lens. Pre- and post-operative visual acuities were recorded.Intra-o and post-operative complications were observed. The follow-up period ranged from 6 to 42 months.Results Implantation of optic capture of the posterior chamber intraocular lens was successfully performed in 13 eyes. The best-corrected-visual acuity ranged from 0.2 to 1.0. No optic axis opaque was found in 10 eyes with optic capture. The major complications of optic capture were lenticular precipitates and posterior synechia of the iris. Intraocular dislocation was found in one case two weeks after the operation.Conclusions Supracapsular implantation with optic capture of the posterior chamber intraocular lens is safe and effective for the treatment of traumatic cataract in school-age children.     

后囊膜划开人工晶状体光学部夹持治疗后发性白内障

目的:评价后囊膜划开联合人工晶状体光学部后囊膜夹持术治疗后发性白内障的临床疗效。方法:对30例(34眼)因后发性白内障在行后囊膜划开联合人工晶状体光学部后囊膜夹持术患者进行回顾性分析,记录术前及术后的最佳矫正视力、屈光度数和眼压。观察手术并发症、术后眼部情况,随访时间为6~24mo。结果:术中34眼人工晶状体光学部后囊膜夹持成功,手术成功率达100%;术后最佳矫正视力>0.5,占59%(20/34),术后患者随访期间均未出现视轴混浊,人工晶状体位置正,无其他严重并发症发生,仅出现短期的炎症反应。结论:后囊膜划开联合人工晶状体光学部后囊膜夹持术是治疗后发性白内障安全、有效的办法,但手术要求有较高的显微操作技巧。     

非染色连续环形撕囊在白色白内障超声乳化中的应用观察

目的:探讨非染色连续环形撕囊超声乳化联合人工晶状体植入术治疗白色白内障的疗效。方法:对458眼白色白内障施行非染色连续环形撕囊超声乳化联合人工晶状体植入术,观察其撕囊成功率、术中的并发症、术后视力、术后角膜水肿反应等指标。结果:患者458眼中撕囊成功441眼(96.3%),17眼(3.7%)囊膜出现放射状撕裂,以剪刀剪出一囊膜瓣再完成撕囊。术中后囊膜破裂9眼(2.0%),术后轻度角膜水肿94眼(20.5%),中度水肿29眼(6.3%),重度水肿8眼(1.7%),水肿均在2～10d内消退,无角膜内皮失代偿。术后第1d视力均有明显的提高,视力>0.3者329眼(71.8%),术后1wk视力>0.5者417眼(91.0%)。结论:非染色连续环形撕囊超声乳化联合人工晶状体植入术治疗白色白内障虽手术操作较为困难,但熟练后成功率较高,术后视力恢复良好。     

Cataract surgery with ciliary sulcus fixation of intraocular lenses in patients with uveitis.

PURPOSE: To describe intentional placement of intraocular lens haptics in the ciliary sulcus of patients with uveitis who are at high risk for postoperative posterior synechiae and lens dislocation. METHODS: We reviewed our experience with 16 eyes of 12 patients with uveitis who underwent cataract surgery with ciliary sulcus fixation of intraocular lenses. Patients were followed for a median of 16.5 months (range, 9 to 44 months) after surgery. We evaluated eyes for surgical technique and the following preoperative and postoperative factors: best-corrected visual acuity, intraocular pressure, anterior chamber cells, and posterior synechiae. The following additional postoperative factors were sought: lens dislocation, lens edge capture, and evidence of pigment dispersion. RESULTS: Posterior synechiae were present in 13 eyes before surgery; postoperative posterior synechiae developed in only three of these eyes. These adhesions resulted in lens edge capture in one eye and limited lens decentration in another. Scant pigment was present on the lens optic or in the anterior chamber, suggesting pigment dispersion, in four eyes. We found no evidence of consistently increased anterior segment inflammation or intraocular pressure after surgery when compared with preoperative levels for this group of patients. Postoperative posterior synechiae were seen more often in eyes that had can-opener anterior capsulotomy than in eyes that had continuous, curvilinear capsulorhexis (P = .036). CONCLUSIONS: Ciliary sulcus fixation allows the intraocular lens to serve as a physical barrier between the iris and the lens capsule remnants. This technique may be useful for reducing the risk of postoperative posterior synechiae in patients with uveitis without increasing the risk of other postoperative problems.     

Functional outcomes of acrylic intraocular lenses in pediatric cataract surgery

PURPOSE: To evaluate the functional outcomes of in-the-bag implantation of acrylic intraocular lenses (IOLs) with posterior continuous curvilinear capsulorhexis (PCCC), without PCCC, with PCCC and anterior vitrectomy, and with PCCC and optic capture in pediatric cataract surgery. SETTING: Pediatric Ophthalmology Service, Guru Nanak Eye Centre, New Delhi, India. METHODS: Forty-two eyes of 25 children were included in this prospective study. All eyes had in-the-bag implantation of an AcrySof IOL (Alcon). Twenty-five eyes had had an anterior continuous curvilinear capsulorhexis (ACCC) (Group A). Seventeen eyes had PCCC along with ACCC (Group B), 4 had anterior vitrectomy combined with PCCC (Group C), and 6 had PCCC with IOL optic capture through the PCCC (Group D). Secondary opacification of the visual axis, visual acuity, and possible complications were observed and analyzed. RESULTS: The mean age of the patients was 78 months (range 36 to 144 months). The mean follow-up was 13 months (range 6 to 18 months). Four eyes (16%) in Group A developed visually significant posterior capsule opacification (PCO) involving the central visual axis and required secondary capsulotomy. All eyes in Groups B, C, and D had a clear visual axis at the last follow-up and did not require a secondary procedure. Minimal postoperative inflammation (ie, aqueous flare and IOL deposits ) was seen in all groups. The mean preoperative decimal best corrected visual acuity (BCVA) in Groups A, B, C, and D was 0.095, 0.055, 0.174, and 0.039, respectively. Postoperatively, the BCVA was 0.54, 0.66, 0.66, and 0.66, respectively. CONCLUSIONS: An optimal-sized ACCC followed by in-the-bag implantation of a foldable acrylic IOL helped maintain a clear visual axis by delaying the onset of PCO and leading to milder PCO. The benefits of a foldable acrylic IOL in pediatric cataract surgery can be increased by combining it with PCCC, with or without anterior vitrectomy, or with optic capture of the IOL.     

晶状体半脱位白内障超声乳化术中囊袋张力环的应用观察

目的:评价晶状体囊袋张力环(capsular tension ring,CTR)在白内障合并晶状体半脱位行超声乳化白内障吸除术中的应用价值。方法:对15例16眼白内障合并晶状体半脱位患者行超声乳化白内障吸除术,术中连续环行撕囊后植入CTR,超声乳化摘除白内障,囊袋内植入后房型人工晶状体,若晶状体半脱位>1/2需植入固定孔型CTR,将CTR固定孔上的聚丙烯线固定于悬韧带离断一侧板层巩膜壁上。结果:所有植入的人工晶状体均位于正位。术后随诊3~9mo,矫正视力0.1~0.4者5眼,0.5~0.8者8眼,>0.8者3眼。结论:在白内障合并晶状体半脱位患者行超声乳化白内障吸除术中植入囊袋张力环是安全有效的方法,有利于保持囊袋的完整,便于后房型人工晶状体植入,防止人工晶状体的偏位,减少手术并发症,术后视力恢复快。