国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
4期
742-744
,共3页
赵一璇%孙靖%肖显文%周玉%张红
趙一璇%孫靖%肖顯文%週玉%張紅
조일선%손정%초현문%주옥%장홍
小角膜%小眼球%先天性白内障%临床表现%治疗
小角膜%小眼毬%先天性白內障%臨床錶現%治療
소각막%소안구%선천성백내장%림상표현%치료
microcornea%microphthalmos%congenital cataracts%clinical manifestation%treatment
目的：探讨小角膜合并先天性白内障患者的眼部临床表现、手术治疗时机及疗效。<br> 方法：回顾性分析2000-01／2012-12在天津医科大学眼科中心接受治疗的先天性白内障合并小角膜患者11例18眼的临床资料，术前检查包括角膜直径（＜9．5 mm ）、眼部异常和全身异常，术后随访至少1a，评价术后视力和并发症等。<br> 结果：患者11例中有先天性白内障家族史4例，18眼中合并虹膜缺损6眼，眼球震颤18眼，原始玻璃体动脉残留1眼。对11例18眼患者施行三种手术方案：（1）行囊外白内障摘除术（ extra capsular extraction of cataract ， ECCE ）者5眼；（2）Ⅰ期行 ECCE ，Ⅱ期行人工晶状体植入术（posterior chamber intraocular lens ，PC-IOL）者4眼；（3）Ⅰ期行ECCE联合PC-IOL植入者9眼。术后患者视力均有明显改善，18眼术后最佳矫正视力0．145±0．0958（0．01～0．20）。 ECCE术中并发症主要为后囊破裂1眼，术后并发症主要为后发性白内障10眼，继发性青光眼2眼。<br> 结论：先天性白内障合并小角膜常伴发虹膜、脉络膜缺损，眼球震颤等合并症，人工晶状体的植入能明显提高患者视力，但术中应注重防范角膜损伤、后囊破裂等并发症，术后加强管理，特别是眼压的监测，以极早防治青光眼等并发症。
目的：探討小角膜閤併先天性白內障患者的眼部臨床錶現、手術治療時機及療效。<br> 方法：迴顧性分析2000-01／2012-12在天津醫科大學眼科中心接受治療的先天性白內障閤併小角膜患者11例18眼的臨床資料，術前檢查包括角膜直徑（＜9．5 mm ）、眼部異常和全身異常，術後隨訪至少1a，評價術後視力和併髮癥等。<br> 結果：患者11例中有先天性白內障傢族史4例，18眼中閤併虹膜缺損6眼，眼毬震顫18眼，原始玻璃體動脈殘留1眼。對11例18眼患者施行三種手術方案：（1）行囊外白內障摘除術（ extra capsular extraction of cataract ， ECCE ）者5眼；（2）Ⅰ期行 ECCE ，Ⅱ期行人工晶狀體植入術（posterior chamber intraocular lens ，PC-IOL）者4眼；（3）Ⅰ期行ECCE聯閤PC-IOL植入者9眼。術後患者視力均有明顯改善，18眼術後最佳矯正視力0．145±0．0958（0．01～0．20）。 ECCE術中併髮癥主要為後囊破裂1眼，術後併髮癥主要為後髮性白內障10眼，繼髮性青光眼2眼。<br> 結論：先天性白內障閤併小角膜常伴髮虹膜、脈絡膜缺損，眼毬震顫等閤併癥，人工晶狀體的植入能明顯提高患者視力，但術中應註重防範角膜損傷、後囊破裂等併髮癥，術後加彊管理，特彆是眼壓的鑑測，以極早防治青光眼等併髮癥。
목적：탐토소각막합병선천성백내장환자적안부림상표현、수술치료시궤급료효。<br> 방법：회고성분석2000-01／2012-12재천진의과대학안과중심접수치료적선천성백내장합병소각막환자11례18안적림상자료，술전검사포괄각막직경（＜9．5 mm ）、안부이상화전신이상，술후수방지소1a，평개술후시력화병발증등。<br> 결과：환자11례중유선천성백내장가족사4례，18안중합병홍막결손6안，안구진전18안，원시파리체동맥잔류1안。대11례18안환자시행삼충수술방안：（1）행낭외백내장적제술（ extra capsular extraction of cataract ， ECCE ）자5안；（2）Ⅰ기행 ECCE ，Ⅱ기행인공정상체식입술（posterior chamber intraocular lens ，PC-IOL）자4안；（3）Ⅰ기행ECCE연합PC-IOL식입자9안。술후환자시력균유명현개선，18안술후최가교정시력0．145±0．0958（0．01～0．20）。 ECCE술중병발증주요위후낭파렬1안，술후병발증주요위후발성백내장10안，계발성청광안2안。<br> 결론：선천성백내장합병소각막상반발홍막、맥락막결손，안구진전등합병증，인공정상체적식입능명현제고환자시력，단술중응주중방범각막손상、후낭파렬등병발증，술후가강관리，특별시안압적감측，이겁조방치청광안등병발증。
AIM: To report the clinical manifestation, curative opportunity and effect of congenital cataracts with microcornea. <br> METHODS: The clinical materials of 18 eyes of 11 patients with microcorneas who underwent surgery for congenital cataracts from January 2000 to December 2012 were retrospectively analyzed.Preoperative examination including corneal diameter ( < 9. 5mm ), ocular abnormalities and systemic anomalies.The visual acuity and various complications were followed up for 1a. <br> RESULTS: The morphologic types of cataract were family history of congenital cataract ( 4 cases ) among 11 patients.Other preoperative ocular abnormalities included aniridia ( 6 eyes ) , nystagmus ( 18 eyes ) and primary vitreous artery residues ( 1 eye ) .Totally 11 patients ( 18 eyes) had been performed the following three different types of operation:1) extra capsular extraction of cataract ( ECCE) was performed in 5 eyes; 2 ) ECCE for the first step and posterior chamber intraocular lens ( PC-IOL) for the second step was performed in 4 eyes;3) ECCE and PC-IOL was performed in 9 eyes.Visual acuity was achieved after surgery, the best-corrected visual acuity ( BCVA ) was 0.145 ±0.0958 ( 0.01-0.20 ).ECCE intraoperative complication was posterior capsule rupture (1 eye).The main postoperative complications were posterior capsular opacification ( 10 eyes ) and secondary glaucoma ( 2 eyes) . <br> CONCLUSION: The main complication in congenital cataracts with microcornea including aniridia, choroidal defect and nystagmus.IOL implantation can significantly improve visual acuity.Patients should pay attention to prevention corneal injury, posterior capsular rupture and etc. However, adequate management of postoperative complications, especially posterior capsular opacification and glaucoma is required.
