儿童先天性白内障不同手术时间行后囊联合前玻璃体切除效果观察

摘要

Objective To compare the effects of phacoemulsification and posterior capsule excision combined with anterior vitrectomy in different time on congenital cataract in children. Methods 46 children (76 eyes) with congenital cataract were treated with phacoemulsification. 26 cases (45 eyes) received posterior capsule excision combined with ante-rior vitrectomy with phacoemulsification (group A). 22 cases (31 eyes) received capsule excision and vitrectomy after pri-mary surgery and posterior capsule opacification appeared ( group B) . All patients were followed up regularly. The effects of surgery were compared. Results The incidence of posterior capsule opacity was 2% in group A and 100% in group B after the primary surgery. There were 32 eyes (71. 11%) and 22 eyes (70. 97%) had best corrected visual acuity over 0. 2, respectively. There was no significant differences between the two groups. There were no serious complications. Con-clusions Phacoemulsification with posterior capsule excision and anterior vitrectomy can effectively prevent the children's PCO. We can also perform anterior capsule excision and anterior vitrectomy surgery when the PCO occurred and the effect is relatively good, but the operation is more complex.%目的 观察比较先天性白内障超声乳化手不同时间联合后囊及前段玻璃体切除术对儿童先天性白内障手术的治疗效果.方法 本研究为回顾性病例系列.收集进行超声乳化手术治疗的先天性白内障患儿46例(76只眼),其中A组26例(45只眼)于术中行后囊联合前段玻璃体切除术,B组20例(31只眼)于术后随诊发生后发障后再行后囊联合前段玻璃体切除术治疗,术后随访6~18个月,观察2组件手术疗效及手术并发症情况.结果 A组后发障发生率为2%,B组仪器手术后后发障发生率为100%.两组最终术后最佳矫正视力提高>0.2者分别为32只眼(71.11%)和22只眼(70.97%),两组间统计学无明显差异.随访显示2组均无严重并发症发生.结论 白内障超声乳化摘除术中联合后囊及前玻璃体一期切除可有效预防儿童后发障的发生.二期后囊及前玻璃体切除手术处理后发障效果也较为良好,但手术相对复杂.