儿童人工晶状体眼后发性白内障的临床分析

Clinical analyse for posterior capsule opacification in children with pseudophakic eyes

目的评价儿童人工晶状体眼后发性白内障的临床特征和掺钕钇铝石榴石（Nd：YAG）激光后囊膜切开术的治疗效果。方法对207例（249眼）3～12岁儿童施行超声乳化白内障吸除联合人工晶状体植入，其中121眼植入聚甲基丙烯酸甲酯硬性人工晶状体（A组），128眼植入Acrysof折叠式人工晶状体（B组），术后随访12～84个月，观察比较两组后发性白内障的发生率、Nd：YAG激光后囊膜切开率以及激光术后视力情况。结果儿童白内障超声乳化吸除联合人工晶状体植入手术中，后发性白内障发生率A组为92．6％，B组为32．9％；Nd：YAG激光后囊膜切开率A组为92．6％，B组为26．6％，两组具有显著性差异（P〈0．01）。146眼经Nd：YAG激光后囊膜切开术后脱盲率为100％，脱残率90．7％。结论对于3—12岁儿童白内障施行超声乳化白内障吸除联合人工晶状体植入术，使用Acrysof折叠式人工晶状体明显降低后发性白内障发生率和Nd：YAG激光后囊膜切开率；Nd：YAG激光后囊膜切开术是儿童人工晶状体眼后发性白内障安全有效的治疗方法。

Objective To study the clinical characteristics of the posterior capsule opacification （PCO） and the outcome of neodymium： yttrium aluminum garnet （Nd：YAG） laser posterior capsulotomy in children with pseudophakic eyes. Methods 207 children with 249 eyes （3 - 12 years old） performed phacoemulsification with posterior chamber intraocular lens （IOL） implantation, including 121 eyes with polymethylmethacrylate （PMMA） IOL（ Group A） and 128 eyes with Acrysof IOL （Group B）. The rate of PCO and the visual acuity of Nd：YAG capsulotomy were followed up for 12 - 84 months. Results There were significant differences in the percentages of PCO and the rate of Nd：YAG capsulotomy between two groups （P 〈 0.01 ）. Group A was associated with more PCO （92.6%） than Group B （32.9%）. The Nd：YAG capsulotomy rate was 92.6% for Group A,and 26.6% for Group B. Among 146 eyes who performed Nd：YAG capsulotomy, 100% patients were relieved from blindness and 90.7% patients obtained corrected visual acuity≥0.3. Conclusion The results suggest that phacoemulsification with Acrysof intraocular lens implantation can effectively reduce the percentages of PCO and the rate of Nd：YAG capsulotomy in children with cataract aged 3 - 12 years old. The Nd：YAG capsulotomy is a safe and effective procedure to remove the PCO in children with pseudophakic eye.