双撕囊联合前部玻璃体切除术在儿童先天性白内障治疗中的应用

Application of double capsulorhexis combined with anterior vitrectomy in children with congenital cataract

目的 观察双撕囊联合前部玻璃体切除在治疗儿童先天性白内障中的疗效.方法 对42例71眼年龄3个月至14岁的先天性白内障患儿实施白内障囊外摘除、后囊连续环形撕囊联合前部玻璃体切除术,联合Ⅰ期或Ⅱ期人工晶状体植入（IOL）,平均随访24个月.结果 42例患儿中有37例61眼术后能检查视力,最佳矫正视力〉0.5者39眼,〉0.3者16眼,〈0.3者6眼.术后并发症：葡萄膜炎9眼、角膜水肿8跟、后发性白内障5眼,人工晶状体偏位、视网膜脱离、黄斑囊样水肿等严重并发症尚未出现.结论 双撕囊联合前部玻璃体切除术联合IOL植入是比较安全有效的治疗儿童先天性白内障的手术方式.

Objective To study the effect of double capsulorhexis combined with anterior vitrectomy in children with congenital cataract.Methods 42 （71 eyes） （age from 3 months to 14 years） underwent posterior continuous circular capsulorhexis （PCCC） and anterior vitrectomy after cataract extraction, and intraocularlens （IOL） were implanted in some eyes.The median follow-up time was 24 months.Results Among the 61 eyes of 37 patients who could do the visual examination,39 eye shada corrected visual acutiy of 0.5 or better, 16 eyes had a corrected visual acutiy of 0.3 or better 6 eyes had a corrected visual acuity of 0.3 or below.The postoperative complications included uveitis in 9 eyes,cornealede main 8 eyes,posterior capsular opacity（PCO） in 5 eyes.Some severe complications such as off centre IOL,cystoid macularedema and retinal detachment did not occur.Conclusion The double capsulorhexis combined with anterior vitrectomy and IOL implanted into eye should be a safe and effective method to prohibit after cataract in children with congenital cataract.