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目的评价人工晶状体(IOL)囊上植入、光学部囊袋后嵌入治疗儿童白内障的临床效果。设计回顾性病例系列。研究对象15例(17眼)儿童先天性白内障患者。方法超声乳化白内障吸除后,后囊连续环形撕囊,直径约4mm,将IOL光学部嵌于后囊后,襻位于囊袋上,使囊袋闭锁。主要指标裸眼视力、眼压、IOL位置及并发症。结果术中17眼按设计的手术方式顺利完成。术后6个月5眼IOL位置从囊袋后向前移位至囊袋前,这其中有4眼发生视轴区混浊,余13眼在随访期间均未出现视轴区混浊。术后6个月的主要并发症为IOL表面沉着物:1级3眼(18%),2级7眼(41%)。虹膜前粘连1眼(6%),后粘连4眼(24%)。瞳孔变形5眼(29%)。结论应用囊上植入、光学部囊袋后嵌入IOL治疗儿童白内障安全有效,可有效预防后发性白内障的发生。
Objective To evaluate the clinical effect of implantation of intraocular lens (IOL) capsule and embedding of the ophthalmic capsule in the treatment of cataract in children. Design retrospective case series. Fifteen patients (17 eyes) with congenital cataract were included in this study. Methods After phacoemulsification, the posterior capsular continuous curvilinear capsulorhexis with a diameter of about 4 mm was placed in the capsular bag after the IOL optics was embedded in the posterior capsule. The capsular bag was locked. The main indicators of uncorrected visual acuity, intraocular pressure, IOL location and complications. Results Intraoperative 17 eyes were successfully completed according to the designed operation method. At 6 months after operation, the position of the 5 IOLs shifted forward from the capsular bag to the anterior capsulotomy. In 4 of them, visual axial opacity occurred. In the remaining 13 eyes, no axial opacity occurred during follow-up. The main complication at 6 months after surgery was IOL surface sub-grade: grade 1, grade 3 (18%) grade 2 grade, grade 7 (41%). Anterior iris adhesions in 1 eye (6%), followed by adhesion of 4 eyes (24%). Pupillary deformation in 5 eyes (29%). Conclusion Intraocular lens implantation and ophthalmic suture insertion in IOL are safe and effective in treating cataract in children, which can effectively prevent the occurrence of recurrent cataract.