少年儿童白内障人工晶状体植入术的初步报告

A primary report of intraocular lens implantation in pediatric patients

目的 了解少年儿童白内障摘出联合人工晶状体植入术后视功能重建情况。方法 对 2 1例 2 3眼少年儿童白内障施行现代显微囊外摘出联合人工晶状体 (IOL)植入术 ,术后随访 6月～ 4 3年 (平均 2 6年 ) ,观察术眼视力恢复情况及手术并发症 ,并了解其角膜内皮细胞的变化。结果 检查合作的 2 0眼IOL植入者术后视力平均为 0 3 8( 0 0 1～1 0 ) ,≥ 1 0者 2眼 ( 10 % ) ;≥ 0 3者 12眼 ( 60 % ) ;≥ 0 0 5者 18眼 ( 90 % ) ;术后视力无明显改善 ( <0 0 5 )者 2眼 ( 10 % )。术眼角膜内皮细胞均较术前减少 ,丢失率为 4 84%± 1 5 2 %。结论 人工晶状体植入术是矫正少年儿童无晶状体眼屈光不正的有效方法。

ObjectiveTo evaluate the effect of visual rehabilitation after extracapsular cataract extraction(ECCE)and intraocular lens(IOL)implantation in pediatric patients.MethodsECCE and IOL implantation were performed in twentythree eyes of 21 patients with cataract,who were under 18 years old.The average period of followup was 2.6 years(range 6 months to 4.3 years).Visual acuity and corneal endothelial cells in the operated eyes were measured before and after surgery.Complications were also investigated during and after the operation.ResultsThe average visual acuity was 038(range 001～10)without glasses,which was much better than the presurgical one.The vision of two eyes(10%)were improved to ≥10.Twelve eyes(60%)got out of the disablement with the vision ≥03,and eighteen eyes(90%) got out of the blind with the vision ≥005.The rate of endothelial cell loss was 484%±152%.ConclusionImplantation of posterior chamber IOLs in pediatric patients with aphakia appears to be effective and safe.Congenital cataract extraction and IOL implantation must be performed as early as possible whether binocular or uniocular one,which induce the visual acuity worse.IOL implantation is the first choice to correct the refractive errors for the aphakia after traumatic cataract extraction.Complicated cataract extraction and IOL implantation correlated with pretreatment condition.The prognosis is dependent on the pathological process before and after the operation.