合并小眼球和（或）小角膜先天性白内障的人工晶状体植入术

Intraocular lens implantation in congenital cataract associated with microphthalmos and/or microcornea

目的探讨合并小眼球和（或）小角膜的先天性白内障的人工晶状体植入术的手术疗效和操作难点。方法对9例（18只眼）眼轴长度为18．1～20．5mm和（或）角膜直径为7．5～9．Omm的先天性白内障患者施行超声乳化白内障吸除联合人工晶状体，术后随访时间（12～60）月。结果术后矫正视力均高于术前矫正视力，脱盲率为93．7％，脱残率16．7％。并发症包括角膜水肿13只眼（72．2％），瞳孔区渗出膜7只眼（38．9％），人工晶状体偏位3只眼（16．7％）。结论对于合并小眼球和（或）小角膜的先天性白内障施行人工晶状体植入术能够有效地改善患者的视功能，但必须注重手术操作技巧，防止并发症的发生。

Objective To investigate the effectiveness and the surgical difficulty of intraocular lens （IOL） implantation in congenital cataract with microphthalmos and/or microcomeaMethnds The study comprised 18 eyes of 9 patients with congenital cataracts.The ocular axial lengths were 18.1-20.5mm.The corneal diameters at the time of surgery ranged from 7.5-9.0mm.All patients underwent phacomulsification with IOL implantation and performed primary posterior continuous curvilinear capsulorhexis （PCCC） and anterior vitrectomy.The visual acuity and various complications were followed up for 12-60 months.Results All eyes ach!eved postoperative corrected visual acuities better than that of the corrected visual acuities before the opera- tion.93.7% patients were relieved from blindness and 16.7% patients obtained corrected visual acuity ≥ 0.3, Complications included corneal edema in 13 eyes （72.2%）, exudative membranes in pupil area in 7 eyes （38.9%）, IOL decentration in 3 eyes （16.7%）.Conclusions Intraocular lens implantation in congenital cataract associated with microphthalmos and/or microcornea is an effective method to improve vision but the precise surgical techniques must be pay attention to in order to avoid complications.