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目的观察先天性白内障摘除术中行后囊连续环形撕囊(PCCC)防治后发性白内障的疗效及可能出现的并发症。方法采用小切口先天性白内障单纯囊外摘除或联合人工晶体植入术,对58例97眼先天性白内障患者进行后囊连续环形撕囊,使晶体后囊中央形成约3～5mm的囊膜缺损区,行前部玻璃切除术,以避免后发障的发生。结果Ⅰ期植入人工晶体50眼。能合作检查视力者中,术后1个月矫正视力≥0.6者18眼,0.5以下42眼;术后3个月矫正视力≥0.6者20眼,0.5以下46眼;术后6～12个月矫正视力≥0.6者21眼,0.5以下50眼。术后一个月第1次复查,无1眼发生后发障,3个月周边部后囊膜混浊40例,撕囊区清亮。6～12个月16眼发生新生膜,10眼少量玻璃体脱出于前房,玻璃体轻度混浊,瞳孔不圆18眼,人工晶体偏位10眼,无1眼发生视网膜脱离。结论后囊连续环形撕囊是一种经济、安全、高效的防止先天性白内障术后后发障的手术方式,适用于不能配合激光治疗的儿童,但存在一定的复发率。
Objective To observe the effect and possible complications of posterior capsular continuous curvilinear capsulorhexis (PCCC) in the prevention and treatment of idiopathic cataract after cataract extraction. Methods Small incision congenital cataract alone extracapsular cataract extraction combined with intraocular lens implantation in 58 cases of 97 cases of congenital cataract patients with posterior continuous curvilinear capsulorhexis, the formation of the central lens capsule about 3 ~ 5mm of the capsule defect District, line anterior resection of the glass in order to avoid the incidence of post-fault. Results I implanted intraocular lens in 50 eyes. Can cooperate to check the eyesight, postoperative 1 month corrected visual acuity ≥ 0.6 were 18 eyes, 0.5 less than 42 eyes; 3 months after correction of visual acuity ≥ 0.6 were 20 eyes, less than 0.5 46; 6 to 12 months after surgery Corrected visual acuity ≥ 0.6 in 21 eyes, 0.5 the following 50 eyes. One month after the first review, no one had occipital disruption, 3 months after the peritoneal opacification in 40 cases, capsulorhexis area clear. In 6 ~ 12 months, 16 eyes developed neovascularization, 10 eyes had a small amount of vitreous prolapse in the anterior chamber, mild vitreous opacity, 18 eyes without pupil, 10 eyes with deviation of intraocular lens and no retinal detachment in 1 eye. Conclusions The posterior continuous curvilinear capsulorhexis is an economical, safe and effective surgical method to prevent postoperative complications of congenital cataract. It is suitable for children who can not cooperate with laser treatment, but there is a certain recurrence rate.