不同术式的白内障手术与儿童后发障形成的比较

Comparing after-cataract formation in children having undergone three different cataract surgeries

目的 探讨预防儿童后发性白内障的手术方式。方法 61例 (74眼 )分为 3组。每组均行前囊连续环形撕囊、白内障吸出及折叠式人工晶状体囊袋内植入。Ⅰ组 2 2眼保留完整后囊 ;Ⅱ组 2 5眼后囊连续环形撕囊 (PCCC) ;Ⅲ组 2 7眼PCCC +前部玻璃体切除术。术后随访 6～ 2 8月。结果 Ⅰ、Ⅱ、Ⅲ组后发障发生率分别是 45 5%、2 8 0 %、3 7% ,Ⅰ组与Ⅱ组比较P >0 .0 5;Ⅰ组与Ⅲ组比较 ,P <0 .0 1。Ⅱ组与Ⅲ组比较P <0 .0 5。 <8岁者后发障发生率 3组依次是 50 %、46 6%、6 3 %。结论 PCCC +前部玻切可有效预防儿童后发性白内障的发生 ,特别是对

ObjectiveTo evaluate the surgical method whic h can effciently prevent the occurrence of after-cataract in children with catara ct.Methods61 children(74eyes) with cataract were divided into 3 g roups.In group Ⅰ,cataract surger with foldable IOL implantation;In group Ⅱ cat aract surgery combined with PCCC and foldable IOL implantation;In grop Ⅲ,catara ct surgery combined with PCCC and anterior vitrectomy and foldable IOL implantat ion.The visual acuity、after-cataract and other complication were followed up f or 12 months (range,6～28months).ResultsThe occurrence of after-cataract in 6-28 months after operation was 10 eyes(45.5%) in the group Ⅰ,7 eyes (28.0%) in the group Ⅱ,1 e yes (3.7%) in the group Ⅲ.There was no statistical difference between group Ⅰ and group Ⅱ,there are significant differences when group Ⅰ and Ⅱ compare with group Ⅲ (χ 2=11.68,P<0.01,χ 2=5.62,P<0.05).In the younger children( <8 years old),the rate of after-cataract was significantly less in cases had a nterior vitrectomy.The best corrected visual acuity in 2 months after operation: 50 eyes ≥0.5 (70.4%),15 eyes 0.1～0.4(21.1%).All surgical eyes had no postopera tive complication,such as vitreous hernia,retinal detachment,cystoid macular ede m a,etc.ConclusionCataract surgery combined with PCCC and anteri or vitrectomy and foldable IOL implantation is a safe surgical method which can effectively prevent the formation of after-cataract in children with cataract, especially in younger children.