儿童后发性白内障合并人工晶状体固定性瞳孔夹持的手术治疗

目的探讨儿童严重后发性白内障合并人工晶状体固定性瞳孔夹持的合理的治疗方法及疗效。方法对14岁以下发生严重后发性白内障的患者中合并人工晶体固定性瞳孔夹持伴有严重的虹膜后粘连或瞳孔膜闭的12只眼进行后发性白内障切除、人工晶状体复位术,部分病人联合前段玻璃体切割术。对虹膜后粘连或瞳孔膜闭者同时进行粘连分离或瞳孔成形术。结果12只眼成功分离虹膜与囊膜粘连并进行后发性白内障切除和人工晶状体复位。其中2只眼行瞳孔成形术,8只眼行前段玻璃体切割术,术后视功能有不同程度的改善。结论伴有严重人工晶状体瞳孔夹持和虹膜粘连或瞳孔膜闭的儿童严重后发性白内障的理想治疗手段是手术切除后发性白内障并进行人工晶状体复位。

Surgical management for complex severe posterior capsule opacification with intraocular lens pupillary capture in childhood

Objective To investigate the optimal method to manage severe posterior capsule opacification accompanied intraocular lens(IOL)pupillary capture in childhood after cataract extraction and IOL implantation.Methods Posterior capsulotomy and IOL reposition were performed in 12 eyes with severe posterior capsule opacification accompanied intraocular lens pupil capture and severe iris posterior synechia under 14 year-old.The posterior iris synechia was separated and the pupillary membrane was excised in some corecleisis cases.Anterior vitrectomy was combined in some cases.Results Posterior capsulotomy and the IOL reposition were successfully performed in all 12 cases.Severe posterior synechia of iris with posterior capsule was separated completely.The pupilloplasty were successfully accomplished in 2 cases with pupillary closure(seclusion of pupil)or occlusion of pupil(corecleisis)respectively.The anterior vitrectomy was also performed in 8 cases.The visual acuity in all cases was improved in different extent.Conclusions The ideal therapy for complex severe posterior capsule opacification with intraocular lens pupil capture caused by severe iris posterior synechia or pupillary membrane was secondary posterior capsulotomy and intraocular lens reposition.