儿童人工晶体植入初步报告

A preliminary report on extracapsular cataract extraction with intraocular lens implantation in children

报告９４只眼儿童白内障囊外摘除联合后房型人工晶体植入随访６～３０个月的结果。９４只眼均顺利植入人工晶体，个别外伤障使用了前段玻璃体切除。术后处理同成年人。术后主要并发症明显高于成年人，主要为葡萄膜炎，特点是前房反应较老年性白内障重，持续时间长，易发生虹膜后粘连和形成后囊膜混浊。经随访，单眼脱盲率为９０．１％，其４９．４％的患儿矫正视力低于０．４。我们认为，对白内障儿童植入人工晶体应持慎重态度，不主张对３岁以下儿童行双眼人工晶体植入。单眼白内障者要由有经验的医生处理。术后要特别重视随访，并进行视力矫正和弱视训练。

Extracapsular cataract extraction(ECCE)with posterior chamber intraocular lens(IOL)implantation was performed on 94 eyes of children who were followed up for 6～3 0 months. IOLs were inserted in all of these eyes successfully with anterior vitrectomy used in several cases with traumatic cataract. The postoperative managements were similar to those in adults, but their complica-tions were severer obviously than those of adults. Uveitis was the main postoperative complication which was characterized by severer anterior chamber reaction, longer duration and easier to form posterior iris synechiae and develop posterior capsular opacity. The follow-up results showed that the unilateral recov-ery rate from blindness is 90.1%,and 49.4%of these patients' corrected visual acuities were below 0.4.Because of the controversy on IOL implantation in children,it is the authors opinion that it should be cautious to perform IOL implantation on children and such an operation is not advocated for children under 3 years old.Children with unilateral cataract should be managed by experienced doctors, and it is very important to follow up carefully,to correct refractive error and carry out amblyopia treatment.