CAJ | 학술논문

目的：探讨在先天性白内障手术中行后囊膜连续环形撕囊联合前部玻璃体切割术的临床疗效及预防后发性白内障的效果。 　　方法：回顾性分析我院眼科中心2011-01/2014-08收治的82例87眼先天性白内障患儿的临床及术后随访资料,根据手术方式分为对照组(38例40眼,采用超声乳化晶状体吸出术+后囊膜连续环形撕囊)、研究组(44例47眼,用超声乳化晶状体吸出术+后囊膜连续环形撕囊+前部玻璃体切割术),比较两组患者的术中、术后并发症,术后1a随访中央视轴区混浊的发生率及术后两组患儿视力分布的情况差异。 　　结果：对照组中央视轴区混浊0级所占比例为37.5%,低于研究组的76.6%,研究组的1级、2级、3级、4级混浊分布比例均低于对照组患儿,研究组的中央视轴区混浊分布显著优于对照组(P<0.05)。对照组患儿视力检测≤0.5者19眼(47.5%),高于研究组7眼(14.89%),对照组>0.5者21眼(52.5%),低于研究组者40眼(85.11%),两组患儿术后1a的视力检测比较差异具有统计学意义(P<0.05),研究组显著优于对照组。两组患者术后第1mo,1a的眼压较术前均显著降低(P<0.05),但组间比较差异不具有统计学意义(P<0.05)。 　　结论：用超声乳化晶状体吸出术+后囊膜连续环形撕囊+前部玻璃体切割术治疗先天性白内障能够显著降低术后中央视轴区混浊程度,同时提高术后视力,能够有效降低后发性白内障的形成。
목적：탐토재선천성백내장수술중행후낭막련속배형시낭연합전부파리체절할술적림상료효급예방후발성백내장적효과。 　　방법：회고성분석아원안과중심2011-01/2014-08수치적82례87안선천성백내장환인적림상급술후수방자료,근거수술방식분위대조조(38례40안,채용초성유화정상체흡출술+후낭막련속배형시낭)、연구조(44례47안,용초성유화정상체흡출술+후낭막련속배형시낭+전부파리체절할술),비교량조환자적술중、술후병발증,술후1a수방중앙시축구혼탁적발생솔급술후량조환인시력분포적정황차이。 　　결과：대조조중앙시축구혼탁0급소점비례위37.5%,저우연구조적76.6%,연구조적1급、2급、3급、4급혼탁분포비례균저우대조조환인,연구조적중앙시축구혼탁분포현저우우대조조(P<0.05)。대조조환인시력검측≤0.5자19안(47.5%),고우연구조7안(14.89%),대조조>0.5자21안(52.5%),저우연구조자40안(85.11%),량조환인술후1a적시력검측비교차이구유통계학의의(P<0.05),연구조현저우우대조조。량조환자술후제1mo,1a적안압교술전균현저강저(P<0.05),단조간비교차이불구유통계학의의(P<0.05)。 　　결론：용초성유화정상체흡출술+후낭막련속배형시낭+전부파리체절할술치료선천성백내장능구현저강저술후중앙시축구혼탁정도,동시제고술후시력,능구유효강저후발성백내장적형성。
?AlM: To evaluate the clinical efficacy of posterior continuous curvilinear capsulorhexis ( PCCC ) combined with anterior vitrectomy in preventing posterior capsule opacification of congenital cataract surgery. ?METHODS:Postoperative clinical follow-up data of 82 cases ( 87 eyes ) with congenital cataract treated in Eye Center of our hospital from January 2011 to August 2014 were retrospectively analyzed. The patients were divided into the surgical control group ( 38 cases, 40 eyes, recieved phacoemulsification + PCCC ) and the study group ( 44 cases, 47 eyes, accepted phacoemulsification+ PCCC + anterior vitrectomy). The incidence of central optic axis opaque and postoperative visual acuity distribution were recorded at 1a follow - up. lntraoperative and postoperative complications were observed. ?RESULTS:The rate of central optic axis opaque grade 0 in control group was 37. 5%, compared to 76. 6% in study groups. The opacity distribution ratio of grade 1,2,3 and 4 in study group were lower than that of control group, and the central optic axis opacity distribution ratio in study group was significantly better than that of control group (P<0. 05). The 19 eyes(47. 5%) of visual acuity testing ≤0. 5 in control group , was higher than the 7 eyes(14. 89%) of that in the study group, The 21 eyes (52. 5%) of visual acuity testing >0. 5 in control group was lower than the 40 eyes ( 85. 11%) of that in study group. The visual acuity between two groups has statistical significance difference after 1a follow-up ( P<0. 05 ) , and the visual acuity in study group was significantly better than that in the control group. The postoperative intraocular pressure at 1mo and 1a follow-up was lower than before operation in two groups ( P<0. 05), but there was no significant difference between two groups in intraocular pressure (P<0. 05). ?CONCLUSlON: Combination of phacoemulsification, PCCC and anterior vitrectomy presents reliable clinical effects on postoperative central optic axis opacity distribution ratio and visual acuity, and it should be adopted to prevent the occurrence of posterior capsule opacification.