儿童折叠式人工晶状体二期植入术

Secondary foldable intraocular lens implantation in children

目的探讨折叠式人工晶状体(IOL)二期植入术矫正儿童无晶状体眼的疗效和手术适应症.方法对57例(71只眼)后囊膜和悬韧带完整或仅中央区后囊膜缺损的儿童无晶状体眼,二期植入丙烯酸酯(Acrysof)折叠式IOL,术后随访3～25个月.结果术后裸眼视力均等于或高于术前矫正视力,其中术后裸眼视力≥0.5有38只眼(53.5%),术后矫正视力≥0.5有60只眼(84.5%).并发症包括虹膜后粘连16只眼(22.5%),前房渗出物11只眼(15.5%),IOL偏位6只眼(8.45%),后发障9只眼(12.7%).结论对于尚存完整或部分后囊膜支撑的儿童无晶状体眼,折叠式IOL植入是一种安全、有效的方法.

Objective To investigate the effectiveness and indication of secondary foldable intraocular lens （IOL） implantation in the management of pediatric aphakia. Methods The crysof acrylic foldable intraocular lens was implanted secondarily in 71 aphakia eyes of 57 children with intact posterior capsule and zonules or capsule rupture at central zone. The postoperative acuity change and surgical complications were followed up for 3-25 months. Results During the followup period, all eyes achieved postoperative uncorrected visual acuities equal or better than that of the corrected visual acuities before the operation. The postoperative uncorrected visual acuities in 38 eyes （53.5%） and corrected visual acuities in 60 eyes （84.5%） reached 0.5 or better. Complications included the posterior synechia of the iris in 16 eyes （22.5%）, exudation in aqueous chamber in 11 eyes （ 15.5% ）, IOL decentration in 6 eyes （8.45%）, after - cataract in 9 eyes （ 12.7 % ）. Conclusions Secondary foldable intraocular lens implantation is a safe and effective method to correct pediatric aphakia with adequate capsular support. The incidence complications requiring re - operation is low.