白内障超声乳化摘除联合不同术式治疗先天性白内障

Phacoemulsification combined with different surgery in treatment of congenital cataract

目的：观察白内障超声乳化摘除联合后囊膜连续环形撕囊及前段玻璃体切除术治疗先天性白内障的疗效。方法：对59例（90只眼）3个月至25岁先天性白内障患者施行白内障超声乳化摘除（超过2岁者植入人工晶状体），其中34例（53只眼）联合后囊膜连续环形撕囊（Ⅰ组），25例（37只眼）联合后囊膜连续环形撕囊及前段玻璃体切除术（Ⅱ组）。随访6～48月，观察并比较两组视力及后囊膜混浊情况。结果：手术后可进行视力检查的40例（60只眼）中，最佳矫正视力／〉0．3者71．67％，Ⅰ组和Ⅱ组比较差异有显著性（P〈0．05），Ⅱ组优于Ⅰ组。后囊膜混浊发生率两组间比较，Ⅰ组为18．87％，Ⅱ组为2．70％，Ⅱ组明显低于Ⅰ组。结论：白内障超声乳化摘除联合后囊膜连续环形撕囊及前段玻璃体切除术治疗先天性白内障优于仅联合后囊膜连续环形撕囊术，可获透明视区，有效预防后发障的形成，同时植入人工晶状体者术后视力均有提高。

Objective To observe effect of Phacoemulsification combined with posterior continuous curvillnear capsulorhexis （PCCC） or with anterior vitrectomy in treatment of congenital cataract. Methods 90 eyes of 59 patients between 3months and 25 years old with congenital cataracts were performed phacoemulsificafion, of which implanted with posterior chamber intraocular lens （IOL） beyond 2 years old. Posterior continuous curvilinear capsulorhexis （ PCCC ） was done in 53 eyes of 34 persons （ Group I ） ; PCCC and anterior vitrectomy were performed in 37 eyes of 25 persons （ Group ]] ）. The visual axis opacification and various complications were followed up for 6 ～48 months. Results Among 60 eyes of 40 patients who could do visual examination ,71.67% patients obtained corrected visual acuity ≥0.3 , of which the difference between Group Ⅰand Group Ⅱ was statistically significant（ P 〈0.05 ）. The Rate of posterior capsular opacities is 18.87% in GroupⅠ and 2.70% in Group Ⅱ, which in Group Ⅱ was significantly less than in Group Ⅰ （ P 〈0.05）. Conclusion Phacoemulsification combined with PCCC and anterior vitrectomy in treatment of congenital cataract is better than with PCCC, which obtained clear optical visual zone, and can prevent after-cataract.