41例先天性白内障手术治疗临床分析

A clinical study on operation management of 41 cases of congenital cataract

目的 探讨先天性白内障的手术时机及方法选择。方法 对41例（67只眼）先天性白内障进行手术治疗，全部采用超声乳化仪吸除白内障、前后囊膜环形撕囊及前段玻璃体切割术，〉1岁者一期植入人工晶状体，进行6～18个月随访，分析判断手术时机、手术方法、术后并发症、术后弱视训练对巩固疗效的重要性。结果 经治疗后所有患者视力有改善征象，表现为明显追光、视物清晰、视力提高，并发症少。结论 先天性白内障适时手术干预是一种有效的治疗方法，关键早发现、早诊断、以便把握手术时机；〉1岁者应一期植入人工晶状体，1～7岁欠矫10％～20％为宜，8岁以后给足人工晶状体度数；后囊膜环形撕囊并行前段玻璃体切割，是预防婴幼儿白内障手术后囊膜混浊最有效的方法；术后及时矫正屈光不正和弱视治疗对提高视力预防弱视很重要。

Objective To evaluate efficacy of surgical time and method of congenital cataract. Methods A retro spective analysis of 67 eyes of 41 children were referred after phacoemulsification with I phase （ 〉 1 years） intraocular lem （IOL） implantation and posterior continuous curvilinear capsulorhexis and anterior vitrectomy was per-formed. Surgical tirre and procedure, complications and treatment of am-blyopia were discussed after operation with 6 - 18 months follow-up. Risuits Vision acuity was improved in all cases after treatment, there were few complication. Conclusion Surgery management is an effective procedure for cong-enital cataract. The time of finding, diagnosis and treatment was very crucial for tie prognosis of congenital cataract. Earlier operated and better vision acuity could be achieved. The I phase intraocular lets （IOL） implantation was performed in children （ 〉 1 years）. The children （ 〉 8 years） were given full power of IOLs ard that （ 1 -7 years） were given few （ 10% -20% ） than normal. Posterior continuous curvilinear capsulorh-exis with anterior vitrectomy was the most effective way to prevent posterior capsular opacificaton after operation which is related with age. The refraction correction and amblyopia treatment were important to improve vision acuity and prevent from amblyopia.