人工晶状体植入术治疗2岁以下婴幼儿白内障的初步临床观察

Preliminary results of intraocular lens implantation in infants with cataract under two years old

目的 探讨白内障摘除前、后撕囊联合前段玻璃体切除及人工晶状体植入术治疗年龄<2岁婴幼儿白内障的可行性。方法 对 2 2例 (2 7只眼 )年龄为 8～ 2 4个月的白内障患儿行白内障摘除、前后撕囊联合前段玻璃体切除及人工晶状体植入术 ,观察术中和术后情况。平均随访时间 12个月。结果 手术均顺利完成。术后 2 6只眼 (96 % )视轴保持透明 ;1只眼视区人工晶状体后出现白色纤维化混浊。瞳孔上移 3只眼 (11% ) ,人工晶状体夹持 2只眼 (7% ) ,虹膜后粘连 4只眼 (15 % )。结论 白内障摘除、前后撕囊联合前段玻璃体切除及人工晶状体植入术治疗年龄 <2岁的婴幼儿白内障 ,可有效保持视轴透明 ,恢复眼部正常解剖结构 ,显著减少并发症的发生 ;视功能的提高有待长期观察。

Objective To explore the feasibility of anterior and posterior capsulorhexis combined with anterior vitrectomy and intraocular lens implantation in infants with cataract under 2 years old.Methods Anterior and posterior capsulorhexis combined with anterior vitrectomy and intraocular lens implantation was performed in 22 cases (27 eyes) of infants with cataract under 2 years old. The results during and after the operation were observed. The mean follow-up time was 12 months. Results All surgeries were performed smoothly. The visual axis remained clear in 26 eyes (96%) after operation,there was white fibrosis and opacification posterior to the intraocular lens in 1 eye and needed re-operation,up drawn pupil in 3 eyes (11%),pupillary capture in 2 eyes (7%) and posterior synechia of the iris in 4 eyes (15%). Conclusions Anterior and posterior capsulorhexis combined with anterior vitrectomy and intraocular lens implantation in infants with cataract under 2 years old can keep visual axis clear and restore the normal anatomy of anterior segment of the eye,the complications are reduced greatly. However, the ultimate visual acuity needs further observation.