CAJ | 학술논문

目的探讨后发性白内障病理情况与术式的相关性.方法二期手术植入人工晶状体的先天性白内障术后患儿60例72只眼,分别对患眼分别进行眼底镜、裂隙灯检查、二期人工晶状体植人手术时术中取出的混浊的机化膜进行组织病理学检查,探讨与一期手术方式的相关性.结果所有患儿晶状体后囊膜周边部均可见残留晶状体上皮细胞向梭形成纤维细胞转化,并可见残留的晶状体上皮细胞形成珍珠小体；采用超声乳化晶状体吸出联合后囊膜抛光术的患儿,后囊膜中央部可见多量增生的成纤维细胞及晶状体上皮细胞；采用超声乳化晶状体吸出联合后囊膜连续环形撕囊及前部玻璃体切割术,后囊膜撕囊孔缘处可见成纤维细胞及排列紊乱的晶状体上皮细胞；后囊膜撕囊孔缘仅见少量残留晶状体上皮细胞.并且术眼中央视区清亮.两种方法中央视区后发性白内障发生率有明显差异.结论儿童先天性白内障术后病理情况提示:采用超声乳化晶状体吸出联合后囊膜连续环形撕囊及前部玻璃体切割术,可有效地预防儿童中央视区后发性白内障的发生.
목적 탐토후발성백내장병리정황여술식적상관성.방법 이기수술식입인공정상체적선천성백내장술후환인60례72지안,분별대환안분별진행안저경、렬극등검사、이기인공정상체식인수술시술중취출적혼탁적궤화막진행조직병이학검사,탐토여일기수술방식적상관성.결과 소유환인정상체후낭막주변부균가견잔류정상체상피세포향사형성섬유세포전화,병가견잔류적정상체상피세포형성진주소체；채용초성유화정상체흡출연합후낭막포광술적환인,후낭막중앙부가견다량증생적성섬유세포급정상체상피세포；채용초성유화정상체흡출연합후낭막련속배형시낭급전부파리체절할술,후낭막시낭공연처가견성섬유세포급배렬문란적정상체상피세포；후낭막시낭공연부견소량잔류정상체상피세포.병차술안중앙시구청량.량충방법중앙시구후발성백내장발생솔유명현차이.결론 인동선천성백내장술후병리정황제시:채용초성유화정상체흡출연합후낭막련속배형시낭급전부파리체절할술,가유효지예방인동중앙시구후발성백내장적발생.
Objective To discuss the correlation of pathological situations and surgical method on posterior capsule opacification.Methods Second stage operation of intraocular lens implantation in children with congenital cataract after surgery in 60 cases (72 eyes) was included in this study.Those eyes were examined with ophthalmoscope,slit lamp,histopathological and electron microscopic.Correlation with the first phase of operation mode was discussed.Results Residual lens epithelial cells were transformed to spindle fiber cell that visible on all the eyes of posterior capsule of lens periphery,and to form Elschnig pearl bodies.The phacoemulsification of lens posterior capsule polishing technique of emulsification was used with posterior central part hyperplasia of fibroblast cells and lens epithelial cells.The phacoemulsification of lens aspiration combined with posterior continuous curvilinear capsulorhexis and anterior vitrectomy,posterior capsulorhexis hole at the edge of the visible fibroblasts and disorganization of the lens epithelial cells was used; only a few residual lens epithelial cells were seen on posterior capsule capsularhexis hole edge,while the central zone of the eyes were all clear.Two methods for central zone posterior capsule opacification incidence rate was obvious difference.Conclusions Using phacoemulsification lens extraction combined with posterior continuous curvilinear capsulorhexis and anterior vitrectomy surgical method can effectively prevent occurrence of posterior capsule opacification on central optic zone on children with congenital postoperative cataract..