中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2013年
5期
395-398
,共4页
鲍永珍%陈宜%吴夕%苗恒
鮑永珍%陳宜%吳夕%苗恆
포영진%진의%오석%묘항
白内障%白内障摘除术%玻璃体切除术%治疗结果%婴儿
白內障%白內障摘除術%玻璃體切除術%治療結果%嬰兒
백내장%백내장적제술%파리체절제술%치료결과%영인
Cataract%Cataract extraction%Vitrectomy%Treatment outcome%Infant
目的 探讨婴儿期双眼先天性白内障手术治疗的安全性和远期术后效果.方法 回顾性系列病例研究.2003年3月至2009年3月北京大学人民医院眼科收治的婴儿期双眼先天性白内障患儿31例(62只眼),所有患儿均接受了同期双眼白内障吸除、后囊膜切除及前段玻璃体切除手术,术后进行密切随访,对末次检查时的单眼视力、双眼视力结果进行统计,并对患儿末次随访时的双眼最佳矫正视力与随访时间进行Pearson相关分析.结果 患儿手术年龄中位数是3个月(0.5～1 1个月),术后随访时间中位数是4.0年(3.0 ～8.5年).术后单眼最佳矫正视力≥0.3共37只眼(59.68％)；双眼最佳矫正视力≥0.3为27例(87.10％)；随着随访时间的延长,患儿年龄的增大,双眼最佳矫正视力逐渐提高(R2=0.135,P=0.0024)；术后斜视7例,占22.58％；眼球震颤13例,占41.94％；视轴区混浊3例,占9.68％；高眼压l例,占3.23％.结论 双眼严重的先天性白内障在婴儿期行白内障手术是安全的,通过及时的屈光矫正和弱视训练,绝大多数患儿能获得良好的生活视力；随着患儿年龄的增长,双眼视力有逐渐提高的趋势.
目的 探討嬰兒期雙眼先天性白內障手術治療的安全性和遠期術後效果.方法 迴顧性繫列病例研究.2003年3月至2009年3月北京大學人民醫院眼科收治的嬰兒期雙眼先天性白內障患兒31例(62隻眼),所有患兒均接受瞭同期雙眼白內障吸除、後囊膜切除及前段玻璃體切除手術,術後進行密切隨訪,對末次檢查時的單眼視力、雙眼視力結果進行統計,併對患兒末次隨訪時的雙眼最佳矯正視力與隨訪時間進行Pearson相關分析.結果 患兒手術年齡中位數是3箇月(0.5～1 1箇月),術後隨訪時間中位數是4.0年(3.0 ～8.5年).術後單眼最佳矯正視力≥0.3共37隻眼(59.68％)；雙眼最佳矯正視力≥0.3為27例(87.10％)；隨著隨訪時間的延長,患兒年齡的增大,雙眼最佳矯正視力逐漸提高(R2=0.135,P=0.0024)；術後斜視7例,佔22.58％；眼毬震顫13例,佔41.94％；視軸區混濁3例,佔9.68％；高眼壓l例,佔3.23％.結論 雙眼嚴重的先天性白內障在嬰兒期行白內障手術是安全的,通過及時的屈光矯正和弱視訓練,絕大多數患兒能穫得良好的生活視力；隨著患兒年齡的增長,雙眼視力有逐漸提高的趨勢.
목적 탐토영인기쌍안선천성백내장수술치료적안전성화원기술후효과.방법 회고성계렬병례연구.2003년3월지2009년3월북경대학인민의원안과수치적영인기쌍안선천성백내장환인31례(62지안),소유환인균접수료동기쌍안백내장흡제、후낭막절제급전단파리체절제수술,술후진행밀절수방,대말차검사시적단안시력、쌍안시력결과진행통계,병대환인말차수방시적쌍안최가교정시력여수방시간진행Pearson상관분석.결과 환인수술년령중위수시3개월(0.5～1 1개월),술후수방시간중위수시4.0년(3.0 ～8.5년).술후단안최가교정시력≥0.3공37지안(59.68％)；쌍안최가교정시력≥0.3위27례(87.10％)；수착수방시간적연장,환인년령적증대,쌍안최가교정시력축점제고(R2=0.135,P=0.0024)；술후사시7례,점22.58％；안구진전13례,점41.94％；시축구혼탁3례,점9.68％；고안압l례,점3.23％.결론 쌍안엄중적선천성백내장재영인기행백내장수술시안전적,통과급시적굴광교정화약시훈련,절대다수환인능획득량호적생활시력；수착환인년령적증장,쌍안시력유축점제고적추세.
Objective To evaluate the long-term visual outcome and complications after bilateral congenital cataract surgery performed prior to 12 months of age.Methods A prospective case study.31 cases (62 eyes) of bilateral congenital cataract were included.All patients received bilateral cataract extraction combined with primary capsulotomy and anterior vitrectomy simultaneously.After the operation,all patients wore aphakic glasses during the follow-up period.The unilateral and bilateral visual acuities (VA) at the last visit were determined and post-operative complications were evaluated,and the relationship between bilateral VA and the length of the follow-up period was also analyzed.Results The median age at surgery was 3.0M (0.5to11M),the median follow-up period was 4.0years (3.0 to 8.5 years).37 out of 62 eyes (59.68％) achieved unilateral best corrected visual acuity equal or better than 0.3.27 among 31 cases (87.1％) achieved binocular best corrected visual acuity equal or better than 0.3.Binocular best corrected visual acuity improved with the increase in the follow-up period and the patients' age (R2 =0.135,P =0.0024).Post-operative complications included strabismus (7 cases,22.58％),nystagmus (13 cases,41.94％),optical opacity (3 cases,9.68％),ocular hypertension (1 cases,3.23％).Conclusions Surgery for congenital cataracts performed prior to 12 months of age is safe,and most of the subjects can achieve functional vision acuity.As these children age,the bilateral best corrected visual acuity can still keep improving.(Chin J Ophthalmol,2013,49:395-398)
