儿童先天性白内障手术治疗临床分析

Clinical analysis of congenital cataract in children

目的:观察手术治疗先天性白内障的临床效果。方法:对97例(136眼)先天性白内障实行白内障摘除、后囊连续环形撕囊、前部玻璃体切除术,部分联合Ⅰ期或Ⅱ期IOL植入。结果:术后最佳矫正视力>0.5者46眼,>0.3者25眼,>0.1者22眼,<0.1者17眼,26眼因年龄小无法进行视力表检查,但能够跟随光亮或有注视目标,较术前有提高。主要并发症有:后囊膜混浊、葡萄膜炎、角膜水肿、IOL偏中心及青光眼等,未见IOL夹持、黄斑囊样水肿、视网膜脱离及眼内炎等严重并发症。结论:白内障摘除、后囊连续环形撕囊、前部玻璃体切除联合IOL植入是治疗先天性白内障安全有效的手段,配合术后戴镜矫正和弱视治疗,可以使大多数先天性白内障致盲儿童达到脱盲及脱残。

AIM：To observe the clinical outcome of congenital cataract surgery in children.METHODS：Ninety-seven cases（136 eyes）underwent posterior continuous circular capsulorexis and anterior vitrectomy after cataract extraction,and intraocular lens（IOL）were implanted in some eyes.RESULTS：The postoperative visual acuity（VA）with correction was better than 0.5 in 46 eyse,better than 0.3 in 25 eyes and better than 0.1 in 22 eyes,respectively.Twenty-six eyes in much younger children who could not receive visual examination had better capability of light following and visual fixation after operation.The postoperative compli-cations included posterior capsular opacity,uveitis,corneal edema,off-centre IOL and glaucoma.Severe complications such as retained IOL,cystoid macular edema,retinal detachment and endophthalmitis did not occur.CONCLUSION：IOL implantation accompanied by posterior continuous circular capsulorexis and anterior vitrectomy after cataract extraction is a safe and effective operation for the treatment of congenital cataract.With spectacle correction and amblyopia treatment after operation,most congenital cataract children can be free from blindness.