Ⅱ期人工晶状体植入联合术后弱视训练重建儿童单眼无晶状体眼视功能

目的观察Ⅱ期人工晶状体植入联合术后弱视训练治疗儿童单眼无晶状体眼视功能重建的效果。方法儿童白内障术后无晶状体眼88例88眼,随机分为观察组44例44眼,对照组44例44眼,2组均行后囊切开及后房人工晶状体植入。术后1个月观察组结合健眼遮盖和弱视治疗仪进行弱视训练,对照组术后不行弱视训练。结果术后1个月观察组视力脱残率与对照组比较差别无统计学意义(P>0.05),术后1a观察组脱残率高于对照组(P<0.01);术后1a观察组视力≥0.5者多于对照组(P<0.05)。观察组术后1个月、1a外伤眼脱残率均高于先天眼(P<0.01,P<0.05)。术后1a外伤眼视力≥0.5者多于先天眼(P<0.01)。对照组术后1个月外伤眼脱残率高于先天眼(P<0.01);术后1a外伤眼与先天眼矫正视力脱残率比较差别无统计学意义(P>0.05);术后1a外伤眼视力≥0.5者高于先天眼(P<0.05)。2组术后并发症发生率差别均无统计学意义(P>0.05)。结论Ⅱ期人工晶状体植入联合术后弱视训练治疗儿童单眼无晶状体眼对儿童视功能的重建优于单纯Ⅱ期人工晶状体植入术。

Reconstruction of postoperative vision in children with monocular aphakia by secondary intraocular lens implantation and amblyopia therapy

Objective To observe the clinical effect of reconstruction of postoperative vision in children with monocular aphakia by secondary intraocular lens ( IOL) implantation and amblyopia therapy. Methods Eighty-eight cases( eighty-eight eyes) with postoperative aphakia eye of cataract in children were randomly divided into observation group and control group,forty-four cases( forty-four eyes) in each group. The two groups were treated with capsulotomy and posterior IOL implantation. Amblyopia therapy was performed on observation group by shading healthy eye and using instrument of amblyopia therapy in one month after surgery. Results There was no statistical difference of the rate of dis-crippledom between the two groups in one month after surgery ( P > 0. 05) . The rate of dis-crippledom and the corrected visual acuity ≥0. 5 were more in observation group than in control group in one year after surgery( P < 0. 01,P < 0. 05) . The rate of dis-crippledom in observation group was more in the aphakia eye of traumatic cataract than in the aphakia eye of congenital cataract in one month and one year after surgery( P < 0. 01,P < 0. 05) . The rate of dis-crippledom in control group was more in the aphakia eye of traumatic cataract than in the aphakia eye of cogenital cataract in one month after surgery( P < 0. 01 ) and there was no statistical difference between them in one year after surgery( P > 0. 05 ) . The corrected visual acuity ≥0. 5 was more in the aphakia eye of traumatic cataract than in the aphakia eye of cogenital cataract in control group in one year after surgery( P < 0. 05) . There was no statistical difference in the rate of postoperative complications between the two groups( P > 0. 05) . Conclusion Reconstruction of postoperative vision in children with monocular aphakia by secondary IOL implantation and amblyopia therapy is a better way than that secondary implantation of artificial simply.