Objective To assess visual function and refractive change in children with congenital cataract after intraocular lens implantation. Methods Forty five children (62 eyes) aged 3m to 10y with congenital cataract were included in the study. The best corrected distant visual acuity(LogMAR)(BCDVA) and stereopsis were followed up for average of 3y. Results BCDVA at 1w postoperatively was 0.74 ±0.35,BCDVA at 1y postoperatively was 0.46 ±0.39,BCDVA at 3y postoperatively was 0.39 ±0.37. BCDVA at 1 and 3y postoperatively was significantly better than that in 1 week postoperatively(P<0.05); and there was no difference between 1y and 3y postoperatively (P >0.05). The rate of corrected vision ≥0.5 in bilateral group was better than in unilateral group. Nine out of 45 children (20%) developed good stereopsis; the rate was 14.3% (4/28) in unilateral group and 29.4% (5/17) in bilateral group. All involved eyes showed a myopic drift 1 and 3y postoperatively; children operated at age less than 2y had a mean myopic shift of -3.50 D, those aged 2-5y had a mean myopic shift of —2.11D, aged greater than 5y had a mean myopic shift of -1.86D. Conclusion Good visual acuity can be achieved after congenital cataract extraction and intraocular lens implantation. One year after surgery is the key period of vision improvement. The range of myopic shift would be narrowed as children grow up.%目的 评价先天性白内障摘除人工晶状体(IOL)植入术后视功能和屈光状态的变化.方法 选取行先天性白内障摘除IOL植入的45例(62眼)患者,其中单眼28例,双眼17例(34眼);＜2岁者16例,2～5岁者17例,＞5岁者12例.随访3年,分别观察单双眼及不同年龄段患者术后最佳矫正LogMAR远视力(BCDVA)、立体视和屈光度的变化.结果 术后1、3年BCDVA明显优于术后1周(P＜0.05),术后1、3年的差异无统计学意义(P ＞0.05).术后3年立体视良好者9例(20%),其中单眼患儿4例(14.3%),双眼患儿5例(29.4%),差异无统计学意义(P ＞0.05).＜2岁患儿术后各时期及2～5岁与＞5岁患儿术后1、3年屈光状态与术中预留IOL屈光度的差异均有统计学意义(均P＜0.05).各年龄段患儿术后3年与术后1年屈光状态的差异均有统计学意义(均P＜0.05);术后1、3年均发生近视漂移,＜2岁患儿术后3年近视漂移-3.50D,2～5岁患儿近视漂移-2.11D,＞5岁患儿近视漂移-1.86D.结论 先天性白内障摘除人IOL植入术可获得较好的视力,术后1年是视力提高的关键期.随着患儿手术时年龄的增大,近视漂移的幅度呈下降趋势.
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