折叠式人工晶状体治疗儿童白内障的初步报告

目的　评价小切口白内障吸除及折叠式人工晶状体囊袋内植入术中采用撕除后囊、切除前段玻璃体技术治疗儿童白内障的临床效果。方法　对 2 8例 (37只眼 )儿童白内障患者行小切口白内障吸除、前后联合撕囊、前段玻璃体皮质切除及折叠式人工晶状体囊袋内植入术 ,其中先天性白内障 2 7只眼 ,外伤性白内障 10只眼。术后随访 3～ 15个月 ,平均 10个月。观察记录并发症发生情况、视力及角膜曲率的变化。结果　先天性白内障患者术后矫正视力均≥ 0 1,16只眼 (5 9 3% )矫正视力≥ 0 5 ;外伤性白内障患者术后矫正视力均≥ 0 3,8只眼 (80 % )矫正视力≥ 0 5。术后 1周 ,1个月和 3个月的手术源性角膜散光度数分别为 (1 18± 0 6 5 )、(0 6 7± 0 5 9)及 (0 6 0± 0 39)D。术后 1个月时 ,手术源性角膜散光度数趋于稳定。随诊中有 5只眼 (13 5 % )出现晶状体后囊膜切开区混浊 ,无其他并发症。结论　小切口白内障吸除及折叠式人工晶状体囊袋内植入术中撕除后囊、切除前段玻璃体治疗儿童白内障具有术后角膜散光小 ,视力恢复快 ,炎性反应轻 ,手术并发症少的优点

Preliminary results of foldable intraocular lens implantation in children with cataract

OBJECTIVE: To evaluate the result of phacoemulsification and foldable intraocular lens implantation (IOL) through a small incision in children with cataract. METHODS: Phacoemulsification with anterior vitrectomy and foldable IOL implantation in the capsular bag was performed in 37 eyes of 28 children aged 3 - 15 years (mean 7 years), including 27 eyes of congenital cataract and 10 eyes of traumatic cataract. The visual acuity, corneal curvature and possible complication were followed up for 10 months (range, 3 - 15 months). RESULT: The best corrected visual acuity (BCVA) of congenital cataract were all >/= 0.1, and 59.3% >/= 0.5. All the BCVA of cases with traumatic cataract >/= 0.3, and 80% >/= 0.5. The surgically induced astigmatism (SIA) was (1.18 +/- 0.65) D, (0.67 +/- 0.59) D and (0.60 +/- 0.39) D in one week, one month, and three months respectively after the operation, and it was stable in the postoperative one month. Secondary cataract occurred in 5 cases (13.5%), and no other complications were found. CONCLUSIONS: Phacoemulsification and foldable IOL implantation through a small incision in children with cataract can reduce early post-operative astigmatism and shorten the period of visual rehabilitation. It is a safe procedure with milder inflammatory reaction and less complication.