儿童先天性白内障手术玻璃体腔内注射地塞米松抑制后发障形成的效果观察

The effect of intravitreal injection of dexamethasone during congenital cataract surgery on preventing the post- cataract formation

目的观察儿童先天性白内障手术玻璃体腔内注射地塞米松抑制后发障形成的效果。方法将30例（30眼）先天性白内障患者分为3组，Ⅰ组10例（10眼）实施传统的“白内障超声乳化＋人工晶状体植入”手术，Ⅱ组10例（10眼）实施“白内障超声乳化＋后囊连续环形撕囊＋前部玻璃体切割＋人工晶状体植入”手术，Ⅲ组10例（10眼）实施“白内障超声乳化＋后囊膜抛光＋人工晶状体植入＋玻璃体腔内注射地塞米松”手术。术后密切随访2年，观察术后2年内后发障的发生率、术后炎症反应和并发症的发生率。结果术后2年内各组患者后发障或中央视轴混浊的发生率，Ⅰ组为80％（8眼）、Ⅱ组为60％（6眼）、Ⅲ组为20％（2眼），Ⅲ组明显低于Ⅰ组或Ⅱ组，Ⅱ组明显低于Ⅰ组，组间比较差别均有统计学意义；术后出现虹膜后粘连Ⅰ组有2眼（20％），Ⅱ组有4眼（40％），Ⅲ组未发现，可见玻璃体腔内注射地塞米松患者术后炎症反应程度较传统组和后囊连续环形撕囊联合前部玻切组明显减轻。结论先天性白内障术中玻璃体腔内注射地塞米松能相对安全有效地抑制后发障的发生，同时能减轻术后炎症反应并降低并发症的发生率。

Objective To investigate the intravitreal injection of dexamethasonc whether can inhibit the formation of after cataract after congenital cataract surgery in children. Methods 30 eyes of 30 patients with congenital cataract were divided into three groups, Ⅰ 10 cases （ 10 eyes）recelved the traditional ＂phacoemulsification and intraocular lens implantation＂ surgery, Ⅱ group of 10 patients （ 10 eyes）received the ＂ phacoemulsification ＋ posterior continuous curvilincar capsulorhexis ＋ anterior vitreetomy ＋ intraecular lens implantation ＂surgery, m group of 10 patients （10 eyes）received the＂ Pbecoemulsification ＋ posterior capsular polishing ＋ artificial lens implantation ＋ dexamethasone intravitreal injection ＂operation. CAuse follow - up af patients after two years, the incidence was observed after 2 years after cataract incidence of postoperative inflammation and complications. Results After 2 years after cataract patients in each group or in the incidence of CCTV axis cloudy, Ⅰ group was 809o （8）, Ⅱ group was 60% （6）,Ⅲ group was 20% （2）,Ⅲ group was significantly lower than that in group Ⅰor Ⅱ group, Ⅲ group was signifcanfly lower than that, the differences between the two groups was statistically significant; after postoperative synechia Ⅰ group 2 （20%）, Ⅱ group 4 （40%）,Ⅲ group was not found. Conclusion Intravitreal injection of dexanmthasone during congenital cataract surgery can be relatively safely and effectively suppress the occurrence of post- cataract,and can reduce postoperative inflammation and reduce the incidence of complications.