促进婴幼儿白内障术后正常屈光发育的手术治疗策略

A surgical treatment strategy in promoting normal refractive development after infantile cataract surgery

目的:回顾性观察Ⅰ期植入IOL治疗婴幼儿白内障术后远期眼球屈光发育和并发症情况。方法:回顾性系列病例研究。对10a内曾行白内障摘除+前后撕(切)囊联合前段玻璃体切割+Ⅰ期IOL(同一种IOL计算公式)植入术的先天性白内障患儿46例92眼的术后并发症、眼轴、矫正视力、屈光状态等进行回顾性分析。结果:患者出现术后并发症者5眼(5%)。患儿术后3a随访矫正视力平均0.40±0.10,术后5a随访矫正视力平均0.51±0.01,术后7a随访矫正视力平均0.71±0.01;术后3a眼轴长度20.04±0.02mm,术后5a眼轴长度22.09±0.09mm,术后7a眼轴长度22.96±0.06mm;术后3a的平均屈光状态(等效球镜度数)为+5.37±0.12DS,术后5a的平均屈光状态+3.20±0.20DS,术后7a的平均屈光状态+0.92±0.20DS。结论:制定合适的手术治疗策略可以安全有效地给予婴幼儿白内障患儿相对正常屈光发育的机会。

AIM: To observe the eye development and complications after primary intraocular lens implantation (IOL) in infantile cataract. METHODS: The postoperative complications, corrected vision, refractive state, ocular axis of 46 patients(92 eyes) with congenital cataract treated by IOL implantation within 10y were retrospectively analyzed. RESULTS: Five eyes (5%) had postoperative complications. In this study, the average corrected visual acuity was 0.40±0.10 at 3a follow-up after surgery, 0.51±0.01 at 5a follow-up after surgery, and 0.71±0.01 at 7a follow-up;The axial length of the eyes was 20.04±0.02mm at 3a after surgery, 22.09±0.09mm at 5a after surgery, and the axial length of the eyes was 22.96±0.06mm at 7a after surgery;The mean refractive state (equivalent spherical lens degree) at 3a after surgery was observed to be +5.37± 0.12 DS,+3.20±0.20 DS at 5a after surgery, and +0.92± 0.20 DS at 7a after surgery. CONCLUSION: The appropriate surgical strategies can give safely and effectively opportunity for the patients with infantile cataract, which also have relatively normal refractive development.