儿童外伤性白内障手术特点及疗效分析

Evaluation of treatment for traumatic cataracts in children.

目的 探讨儿童外伤性白内障的手术特点和临床疗效。方法 对143例3～14岁外伤性白内障患儿采用不同术式联合不同类型人工晶状体(IOL)植入,术后随访18月,对视力及并发症等进行临床分析。结果 术后脱盲率为94.4％,脱残率为80.9％;3～7岁和8～14岁各年龄段术后脱残率比较差异具有显著性(P<0.05);应用超声乳化吸出术和植入肝素处理的聚甲基丙烯酸甲酯(PMMA)硬性IOL、疏水性丙烯酸甲酯(Acrysof)折叠式IOL,可降低后囊浑浊的发生。结论 虽然儿童外伤性白内障的手术效果受多种因素影响,但是经过妥当的手术治疗仍可获得较好的效果。

Objective To investigate the surgical characteristic and clinical effects for traumatic cataracts in children. Methods Among 143 eyes with traumatic cataract aged 3-14 years old, different surgical ways with various types of intraocular lens (IOL) implantation were performed. The visual acuity and possible complications were followed up for a mean periods of 18 months.Results After operation, 94.4% patients were relieved from blindness, 80.9% patients obtained corrected vistion≥0.3. There were significant differences in patients obtained corrected vision ≥ 0.3 between the 3-7 years old group and the 8-14 years old group ( P < 0.05). In 76 eyes with secondary cataract, the incidence of posterior capsule opacification was reduced by the use of phacoemulsification, implantation with heparin modified polymethylmethacrylate(PMMA) IOL or Acrysof IOL. Conclusion Although the surgical effects with traumatic cataracts in children are influenced by many facts, better visual acuity can be achieved if appropriate surgical management is adopted.