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目的 评价不同年龄段先天性核性白内障的特征及囊外白内障摘除术或联合后房型人工晶状体植入术的临床疗效。方法 对 38例 (76只眼 )先天性核性白内障患者按年龄段以不同术式进行白内障手术 ,术中手术显微镜直视下观察后囊膜下混浊的特征 ;术后平均随访 6个月 ,对手术并发症及视力变化情况进行分析。结果 术中发现后囊膜下混浊随年龄呈进行性发展 ,混浊面积与晶状体混浊核相当 ;各年龄段术后矫正视力分布差异有显著性 (χ2 =2 7 84,P <0 0 0 5 ) ;术后后囊膜混浊的发生率与患者年龄呈负相关性 (r =- 0 96 92 ,P <0 0 5 ) ;在年龄 3～ 12岁患者中 ,2只眼术后发生人工晶状体瞳孔夹持。结论 先天性核性白内障可伴发后囊膜下型白内障 ,发病机制尚待进一步研究 ;同类型先天性核性白内障手术的疗效主要取决于患者手术的年龄 ;儿童白内障术后并发症应及早诊治。
Objective To evaluate the clinical characteristics of congenital nuclear cataract in different age groups and extracapsular cataract extraction combined with posterior chamber intraocular lens implantation. Methods Thirty-eight patients (76 eyes) with congenital nuclear cataract underwent cataract surgery by different surgical procedures. The characteristics of posterior subcapsular opacity were observed under the operation microscope. The average follow-up time was 6 months, Analysis of surgical complications and changes in visual acuity. Results The posterior subcapsular opacity was found to be progressively developed with age. The opacification area was similar to that of lens opacification nucleus. There was significant difference in postoperative corrected visual acuity (χ2 = 2 7 84, P 0 05) ; The incidence of posterior capsular opacity was negatively correlated with the age of the patients (r = - 0 96 92, P <0 05); in the age group 3 to 12 years old, the incidence of intraocular lens pupil Hold. Conclusions Congenital nuclear cataract may be associated with posterior subcapsular cataract, the pathogenesis remains to be further studied; the efficacy of congenital nuclear cataract surgery of the same type depends mainly on the age of the patient; cataract surgery complications should be treated early .