儿童白内障手术时机及手术方法的研究

Clinical analysis for thirty cases of pediatric cataract.

目的探讨儿童白内障手术时机及方法选择。方法儿童白内障30例（50眼）进行手术治疗。手术方法：3岁以下者为白内障吸出和后囊环形撕囊，部分采用人工晶状体二期植入；≥3岁者为小切口超声乳化、后囊环形撕囊或合并前段玻璃体切除联合一期人工晶状体植入。术后进行5～12个月随访，分析判断适宜的手术时机和手术方法，并观察术后并发症以及弱视训练时巩固疗效的意义。结果所有患者术后视力均有改善，表现为明显追光、视物清晰、视力提高。出现后囊浑浊足儿童白内障常见的术后并发症，经激光治疗取得一定疗效。结论儿童白内障手术治疗的效果是肯定的。宜早发现、早诊断，以便把握手术时机。不同年龄的儿童白内障应采取不同的手术方法。

Objective To evaluate efficacy of surgical time and method of prdiatrie cataract. Methods A retrospective analysis of 50 eyes of 30 children were referred after phacoemulsification with Ⅰ （≥3 years） or Ⅱ phase （ 〈3 years） intraocular lens （IOL） implantation was performed. Posterior continuous eurvilinear capsulorhexis and anterior vitrectomy were used in some cases. Surgical time and procedure, complications and treatment of amblyopia were discussed after operation with 5 ～ 12 months follow -up. Results Vision acuity was improved in all cases after treatment. Efficacy of using Nd ：YAG laser to treating posterior capsular opacification （PCO） that was the main postoperative complication was proved. Conclusions Surgery management was an effective procedure for pediatric cataract. The time of finding, diagnosis and treatment was very crucial for the prognosis of cataract. Earlier operated and better vision acuity could be achieved. Power of IOLs was calculated using SRK-Ⅱ formula and choosed according to childreng age. Posterior continuous curvilinear capsulorhexis with or without anterior vitrectomy was the effective way to prevent PCO after operation which was related with age.