不同手术入路治疗婴儿期白内障的疗效及安全性分析

Efficacy and Safety of Different Surgical Approaches in Infantile Cataract Surgery

【目的】探讨不同手术入路治疗婴儿期白内障的疗效及安全性。【方法】选取2015年7月至2019年9月平利县医院收治的86例(137眼)白内障患儿,根据手术入路方式分为前入路组(n=47)与后入路组(n=39)。对出院后患儿随访3年,比较两组最后一次随访时单眼最佳矫正视力和双眼最佳矫正视力、并发症发生情况及术前、术后6个月、术后1年、术后3年眼轴长度、角膜曲率。【结果】两组术前、术后6个月、术后1年、术后3年眼轴长度、角膜曲率比较,差异无统计学意义(P>0.05);两组术后6个月、术后1年、术后3年眼轴长度均显著长于术前,角膜曲率均显著小于术前(P<0.05)。两组最后一次随访单眼、双眼最佳矫正视力比较,差异无统计学意义(P>0.05)。两组虹膜粘连、人工晶状体移位、后发性白内障发生率比较,差异无统计学意义(P>0.05);前入路组斜视、眼球震颤发生率显著低于后入路组(P<0.05)。【结论】后入路、前入路婴儿期白内障手术均能有效治疗白内障,其中前入路手术方式能减少术后并发症发生情况,具有较高临床应用价值。

【Objective】To observe the efficacy and safety of different surgical approaches in infantile cataract surgery.【Methods】A total of 86 cases(137 eyes)of pediatric cataract patients treated in our hospital from July 2015 to September 2019 were included in the study.The patients were divided into an anterior approach group(47 cases)and a posterior approach group(39 cases)according to the surgical approaches.The children were followed up for 3 years after discharge.The axial length and corneal curvature of the two groups were measured and compared preoperatively,6 months postoperatively,1 year postoperatively,and 3 years postoperatively.The best corrected visual acuity of one eye and both eyes at the last follow-up visit,as well as the incidence of complications,were also compared between the two groups.【Results】There were no significant differences in the axial length and corneal curvature between the two groups preoperatively,6 months postoperatively,1 year postoperatively,and 3 years postoperatively(P>0.05).The axial lengths at 6 months postoperatively,1 year postoperatively,and 3 years postoperatively were significantly longer than those preoperatively,and the corneal curvatures were significantly smaller than those preoperatively in both groups(P<0.05).There were no significant differences in the best corrected visual acuity of one eye and both eyes at the last follow-up visit between the two groups(P>0.05).There were no significant differences in the incidences of iris adhesions,intraocular lens displacement,and secondary cataracts between the two groups(P>0.05).The anterior approach group had significantly lower incidences of strabismus and nystagmus than the posterior approach group(P<0.05).【Conclusion】Both posterior and anterior approaches in infantile cataract surgery can effectively treat cataracts.The anterior approach can reduce postoperative complications and has better clinical application value.