三种不同术式治疗儿童先天性白内障疗效比较

Comparison of effect of three kinds of surgical techniques in treatment of congenital cataract

目的探讨不同手术方法治疗小儿先天性白内障的术后效果。方法将87例(120眼)白内障患儿分为三组;A组30例(42眼)采用白内障囊外摘除术治疗;B组28例(38眼)采用白内障超声乳化吸出及行后囊膜连续环形撕囊术;C组29例(40眼)采用白内障超声乳化吸出、后囊膜连续环形撕囊联合前段玻璃体切割术;≥2岁的患儿施行I期人工晶状体植入;术后随访3年,比较观察三组术后并发症和视力恢复情况。结果治疗后3组患儿视力均有提高;A组发生后囊膜混浊比B、C两组严重,经统计学分析有明显的差异(P<0.05)。结论白内障超声乳化吸出、后囊膜连续环形撕囊术联合前段玻璃体切割术治疗先天性白内,能更有效减少儿童先天性白内障术后后发性白内障的发生。

Objective To explore the efficacy and safety of three different surgical techniques on congenital cataract on children. Methods Total 87cases（ 120 eyes） with congenital cataract,divided into group A, group B and group C,were retrospectively analyzed. Group A with 30 patients （42 eyes） were treated with extracapsular cataract extraction, while the total 28 patients（ 38 eyes） of group B were treated with phacoemulsification and posterior continuous curvilinear capsulo- rhexis ;And Group C with 29 patients （40 eyes） were treated with phaeoemulsification, posterior continuous curvilinear capsulorhexis and anterior vitreetomy. Children at two of or more years old were implanted intraocular lens（1OL） at the surgical time. Complications and vision recovery were compared between these groups after operation with 3 years follow - up. Results Visual acuity of three groups were improved. The rate of posterior capsular opacities of group A was sig- nificantly more than the other two groups （P 〈 0. 05 ）. Conclusion Phacoemulsification, posterior continuous cmwilinear eapsulorhexis and anterior vitrectomy was better than other treat techniques, which could prevent after - cataract.