CAJ | 학술논문

目的探讨儿童白内障手术疗效及术后视力康复.方法观察2005年7月至2009年11月手术的45例(76只眼)儿童白内障患儿,行白内障摘除术+后囊膜环形撕囊术(PCCC)+前部玻璃体切除术33例(64只眼),双眼白内障患儿同时手术,其中28例(58只眼)2岁以后再次行Ⅱ期人工晶状体植入术,;行白内障摘除术+后囊膜环形撕囊术(PCCC)+前部玻璃体切除术+人工晶状体植入术9例(9只眼);行白内障摘除术+人工晶状体植入术3例(3只眼).对手术年龄、手术方式、术后并发症及术后远期视力等进行回顾性分析,随访4～55个月,平均34.5月.结果 33例矫正视力在0.3以上,手术脱残率73.3%,5例矫正视力在0.05～0.3,手术脱肓率84.4%,2例矫正视力在0.05以下.5例患儿因年龄小不能合作检查视力,但能追随光亮或注视目标.后发障发生率为6.58%,双眼同时手术与同期单眼手术术后并发症差异无统计学意义(P＞0.05).结论白内障摘除术+后囊膜环形撕囊术(PCCC)+前部玻璃体切除术联合人工晶状体植入术是治疗儿童白内障安全有效的措施,儿童白内障双眼同时手术是安全的.坚持弱视训练是儿童白内障术后获得良好视力,重建视功能的关键.
목적 탐토인동백내장수술료효급술후시력강복.방법 관찰2005년7월지2009년11월수술적45례(76지안)인동백내장환인,행백내장적제술+후낭막배형시낭술(PCCC)+전부파리체절제술33례(64지안),쌍안백내장환인동시수술,기중28례(58지안)2세이후재차행Ⅱ기인공정상체식입술,;행백내장적제술+후낭막배형시낭술(PCCC)+전부파리체절제술+인공정상체식입술9례(9지안);행백내장적제술+인공정상체식입술3례(3지안).대수술년령、수술방식、술후병발증급술후원기시력등진행회고성분석,수방4～55개월,평균34.5월.결과 33례교정시력재0.3이상,수술탈잔솔73.3%,5례교정시력재0.05～0.3,수술탈황솔84.4%,2례교정시력재0.05이하.5례환인인년령소불능합작검사시력,단능추수광량혹주시목표.후발장발생솔위6.58%,쌍안동시수술여동기단안수술술후병발증차이무통계학의의(P＞0.05).결론 백내장적제술+후낭막배형시낭술(PCCC)+전부파리체절제술연합인공정상체식입술시치료인동백내장안전유효적조시,인동백내장쌍안동시수술시안전적.견지약시훈련시인동백내장술후획득량호시력,중건시공능적관건.
Objective To evaluate the effects of pediatric cataract operation and rehabilitation of postoperative visual function. Methods Operation was performed on 45 cases (76 eyes) of pediatric cataract from July 2005 to November 2009. Of 33cases (64eyes) underwent posterior continuous curvilinear capsulorhexic (PCCC) and anterior vitrectomy after cataract extraction, and operation was performed simultaneously on bilateral pediatric cataract, 28cases (58eyes) underwent secondary intraocular lens (IOL) implantation at the age of above 2,9 cases (9eyes) underwent PCCC, anterior vitrectomy and IOL implantation after cataract extraction; 3 cases (3eyes) underwent IOL implantation after cataract extraction. Retrospective analysis was performed about the operation age, the operation methods and the postoperative complication, and the long-term vision recovery was recorded throughout the 34.5-month mean follow-up (range 4-55months). Results The postoperative best-corrected visual acuity was better than 0.3 in 33 cases, among 0.05 to 0.3 in 5 and below 0.05 in 2. Five eyes in much younger children who could not receive visual acuity examination had better capability of light following and visual fixation after operation. 73.3% patients were relieved from disability and 84.4% patients were relieved from blindness on treatment of the amblyopia. The incidence of posterior capsular opacification was 6.58%. Between the simultaneous bilateral group and the single eye group, there was no significant difference in the postoperation complications (P ＞0.05). Conclusions IOL implantation with posterior continuous curvilinear capsulorhexic (PCCC) and anterior vitrectomy after cataract extraction is a safe and effective operation for the treatment of pediatric cataract. Operation is safe on bilateral pediatric cataract. The amblyopia treatment after operation is the key to obtaining good visual acuity and building visual function.