人工晶状体植入术治疗2岁以下婴幼儿白内障的初步临床观察

目的　探讨白内障摘除前、后撕囊联合前段玻璃体切除及人工晶状体植入术治疗年龄<2岁婴幼儿白内障的可行性。方法　对 2 2例 (2 7只眼 )年龄为 8～ 2 4个月的白内障患儿行白内障摘除、前后撕囊联合前段玻璃体切除及人工晶状体植入术 ,观察术中和术后情况。平均随访时间 12个月。结果　手术均顺利完成。术后 2 6只眼 (96 % )视轴保持透明 ;1只眼视区人工晶状体后出现白色纤维化混浊。瞳孔上移 3只眼 (11% ) ,人工晶状体夹持 2只眼 (7% ) ,虹膜后粘连 4只眼 (15 % )。结论　白内障摘除、前后撕囊联合前段玻璃体切除及人工晶状体植入术治疗年龄 <2岁的婴幼儿白内障 ,可有效保持视轴透明 ,恢复眼部正常解剖结构 ,显著减少并发症的发生 ;视功能的提高有待长期观察。

Preliminary results of intraocular lens implantation in infants with cataract under two years old

Objective To explore the feasibility of anterior and posterior capsulorhexis combined with anterior vitrectomy and intraocular lens implantation in infants with cataract under 2 years old.Methods Anterior and posterior capsulorhexis combined with anterior vitrectomy and intraocular lens implantation was performed in 22 cases (27 eyes) of infants with cataract under 2 years old. The results during and after the operation were observed. The mean follow-up time was 12 months. Results All surgeries were performed smoothly. The visual axis remained clear in 26 eyes (96%) after operation,there was white fibrosis and opacification posterior to the intraocular lens in 1 eye and needed re-operation,up drawn pupil in 3 eyes (11%),pupillary capture in 2 eyes (7%) and posterior synechia of the iris in 4 eyes (15%). Conclusions Anterior and posterior capsulorhexis combined with anterior vitrectomy and intraocular lens implantation in infants with cataract under 2 years old can keep visual axis clear and restore the normal anatomy of anterior segment of the eye,the complications are reduced greatly. However, the ultimate visual acuity needs further observation.