两种先天性白内障手术方式预防后发性白内障的比较

目的比较2种先天性白内障手术方式预防后发性白内障的临床效果。方法回顾性分析先天性白内障患者89例（98眼）,按手术方式分为2组,A组42例（47眼）为超声乳化白内障摘出＋人工晶状体植入＋后囊膜撕囊术组;B组47例（51眼）为超声乳化白内障摘出＋人工晶状体植入＋后囊膜撕囊＋前段玻璃体切割术组,分别观察2组术后视力和后发性白内障的发生情况。结果A组发生后发性白内障者24眼,占51.06%;其中21眼行YAG激光后囊膜切开,3眼不合作者行手术后囊膜切开术。B组发生后发性白内障者10眼,占19.61%;其中8眼行YAG激光后囊膜切开术,2眼不合作行手术后囊膜切开术。2组术后后发性白内障发生率的比较,差异有统计学意义（P=0.001）。结论与超声乳化白内障摘出＋人工晶状体植入＋后囊膜撕囊术相比,超声乳化白内障摘出＋人工晶状体植入＋后囊膜撕囊＋前段玻璃体切割术能更好地减少先天性白内障术后后发性白内障的发生率。

Comparison of prevention effectiveness of two operation fashions on posterior capsular opacity in congenital cataract patients

Objective To explore the way of reducing the formation of posterior capsular opacity （PCO） after cataract surgery is of an important significance for recovery of vision. This study was to compare the incidence of PCO after phacoemusification ＋ posterior capsule capeulorhexis and phacoemusification ＋ posterior capsule capculorhexis ＋ anterior vitrectomy in children with congenital cataract. Methods This study was a retrospective analysis. The children with congenital cataract were divided into phacoemusification ＋ posterior capsule capeulorhexis surgery group and age-matched phacoemusification ＋ posterior capsule capculorhexis ＋ anterior vitrectomy group. The visual acuity and incidence of PCO were recorded. Results The mean age of 89 patients was 4.73 ±2.57 years（range 2 - 12 years） ,and 52 cases were male （58. 432% ）. Twenty-four eyes in phacoemusification ＋ posterior capsule capculorhexis group developed PCO （24/47,51.06%） , in which 21 eyes accepted YAG laser and the other 3 eyes received the surgery of posterior capsule discission. Ten eyes in phaeoemusification ＋ posterior capsule capculorhexis ＋ anterior vitrectomy group occurred PCO postoperatively （ 10/51 , 19.61% ） , and 8 eyes were treated by YAG laser and 2 eyes received the surgery of posterior capsule discission. An significant difference was found in PCO incidence between two groups（x2 = 10. 682,P = 0. 001 ）. The best corrected vision after surgery was ≥ 0. 5 in 42 eyes （42.86%） and 0.02 - 0.4 in 51 eyes （52.04%） in all the patients. No severe complication was found in both groups. Conclusion Compared with phacoemusification ＋ posterior capsule capculorhexis surgery, phacoemusification ＋ posterior capsule capculorhexis ＋ anterior vitrectomy seems to be a better approach to the prevention of PCO in children.