先天性白内障后囊膜的特征及手术处理方式的选择

目的 探讨先天性白障后囊膜的特征，总结各种后囊膜的处理方式。设计 回顾性病例系列。研究对象 广州市妇女儿童医疗中心眼科2012年2月至2014年6月治疗的先天性白内障患儿70例（118眼）。方法 回顾患者的病例资料，结合手术录像视频对先天性白内障后囊膜术中可见情况及处理方式进行回顾性分析。主要指标 后囊膜的形态、颜色、性状等特征，后囊膜的处理方式及术后并发症。结果 118眼中91眼（77.11%）后囊膜透明，27眼（22.88%）后囊膜异常。其中12眼（10.17%）后囊膜中央混浊、2眼（1.69%）后囊膜后突菲薄、2眼（1.69%）后囊膜中央缺损、2眼（1.69%）后囊膜混浊并血管伴行、 9眼（7.63%）后囊膜与前囊膜相贴。后囊膜的处理需单独或联合运用电子撕囊仪、前部玻璃体切割头及撕囊镊等。56眼植入IOL，均未发生夹持，4眼IOL偏位。15眼（12.71%）出现后囊膜混浊，需要二次手术。结论 先天性白内障后囊膜异常约占五分之一，其中以中央部混浊较常见。对异常后囊膜的处理需要联合使用电子撕囊及玻璃体切除等各类操作技术。（眼科，2018, 27：91-94）

The characteristics and management of posterior capsule in congenital cataract

Objective To discuss the characteristics and management of posterior capsule in congenital cataract. Design Retrospective case series．  Participants Seventy cases (118 eyes) of congenital cataract in Guangzhou Children and Women’s medical center from 2012 to 2014. Methods Clinical data of the posterior capsules and surgical video were reviewed retrospectively. Main Outcome Measures The characteristics of posterior capsule（morphology,  color,  trait, etc）,  managements,  postoperative outcomes. Results The posterior capsule in 91 eyes (77.11%) of all 118 eyes was thansparent. The abnormalities were observed in 27 eyes (22.88%),  including central opacity in 12 eyes(10.17%),  protuberance backward and thin posterior capsular in 2 eyes (1.69%),  central defect in 2 eyes(1.69%),  vascularization posterior capsular in 2 eyes (1.69%) and the anterior and posterior capsular adherent in 9 eyes (7.63%). Diathermy capsulotomy alone or a combination of vitrectomy and capsulorhexis using forceps were performed. Of the 56 eyes that had an intraocular lens (IOL),  there were 4 IOL decentration postoperatively. Posterior capsule opacity developed in 15 eyes (12.71%). Conclusions Posterior capsular anomalies were about 20% in pediatric congenital cataract eyes, in which central opacity was frequent. Handling of abnormal posterior capsule often requires a combination of several kinds of operating equipments. （Ophthalmol CHN,  2018, 27：91-94）