儿童白内障手术并发症的研究进展

摘要

儿童白内障手术步骤较多,儿童眼的解剖学特点及白内障的不同状态常常需要变更手术操作技术,术中、术后并发症较成人多,术后随访观察须严密,视力重建需要家长的长期配合与付出,这些都使儿童白内障的治疗具有挑战性.近年来,儿童白内障手术并发症的研究领域有了以下更新:23G及25G玻璃体切割机用于儿童白内障手术,使儿童白内障摘出术实现无缝线;多中心、前瞻性随机对照研究——美国婴儿无晶状体眼的治疗项目(IATS)的近期、中期研究结果已经逐步报道;大样本、远期观察的回顾性研究对儿童白内障术后眼内出血、眼内炎、青光眼相关不良事件、视轴再混浊、视网膜脱离等并发症及其结局都有了新的认识.本文回顾近年相关文献,就儿童白内障术中、术后并发症进行综述,帮助临床医师进一步理解和重视儿童白内障手术并发症及其防范、随访及处理.%The procedures of pediatric cataract surgery are much complicated than those in adults.The ocular anatomy of children is special and the morphology of the cataract usually require alternative surgical techniques.The complications of pediatric cataract are common and the follow-up is extensive.Vision restoration needs long process which require parental dedication.These factors make the treatments of pediatric cataract challenging.Recently,the update on pediatric cataract surgery complications includes:the use of 23-gauge and 25-gauge vitrectors in pediatric cataract surgery allow for potentially sutureless technique.Infant Aphakia Treatment Study (IATS),which is a multicenter,randomized,clinical trial comparing cataract surgery with or without intraocular lens (IOL) implantation in infants,has reported series of early stage and medium-long term outcomes;large population and long term retrospective study showed the new survey in bleeding,endophthalmitis and glaucoma-relative adverse events,visual axis opacities,and retinal detachment (RD) after pediatric cataract surgery.Complications of pediatric cataract were elucidated in this review in order to help the ophthalmologists to understand them.