后囊膜截开联合前段玻璃体切割术在先天性白内障手术中的应用

Posterior capsulorhexis with anterior vitrectomy for congenital cataract

目的 :探讨后囊膜截开联合前段玻璃体切割术 (PCCC +AV )在先天性白内障手术中的应用效果。方法 :对先天性白内障患儿者 5 5例 ( 88眼 )进行回顾性研究。行晶状体吸除术 42眼 ,其中 3 8眼联合PCCC +AV术。行晶状体吸除联合人工晶体植入术 44眼 ,其中联合PCCC +AV术 15眼。随访半年到 3年 ,观察视轴混浊、前房纤维渗出、虹膜膜后粘连、人工晶体夹持、黄斑囊样水肿和视网膜脱离等发生情况 ,并进行统计学分析。结果 :术中行PCCC +AV的患儿视轴混浊发生率明显低于未行PCCC +AV的患儿 ,两者有显著性差异 (P <0 0 1)。而前房纤维渗出、虹膜膜后粘连、人工晶体夹持的发生率无显著性差异 (P >0 0 5 )。各组均无一例发生黄斑囊样水肿和视网膜脱离。结论 :在先天性白内障手术中运用后囊膜截开联合前段玻璃体切割术 ,安全易掌握 ,可有效预防后发障 ,主要用于 0～ 5岁的患儿。

Objective:To investigate the clinical effects of posterior capsulorhexis with anterior vitrectomy(PCCC+AV) for congenital cataract. Methods:88 eyes of 55 congenital cataract children were followed up for 6 months to 3 years.42 eyes had lens aspiration,38 eyes of them combined with posterior capsulorhexis with anterior vitrectomy.44 eyes had lens aspiration with IOL implatation,15 eyes of them combined with posterior capsulorhexis with anterior vitrectomy.The condition of clear of optic axis,anterior chamber fibrous exudation,iris posterior synechia,IOL capture,macular edema and retina detachment in these eyes were recorded. Results:The incidence of optic axis opaque in the children with PCCC+AV was significantly lower than that in the children without PCCC+AV(P<0 01),while the incidence of anterior chamber fibrous exudation,iris posterior synechia,IOL capture between these two group was no significant difference(P>0 05).No child with macular edema and retina detachment was found. Conclusions:The posterior capsulorhexis with anterior vitrectomy for congenital cataract is a safe,easy and efficient method to prevent PCO,especially for the patient younger than 5 years old.