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目的探讨25G玻璃体切割手术系统经角膜切口治疗婴儿先天性白内障的效果及安全性。方法回顾性分析15例(30只眼)使用25G玻璃体切割手术系统经角膜切口行前囊环形切除、晶状体切除、后囊环形切除、前部玻璃体切除术治疗婴儿先天性白内障的临床资料,观察手术时间、切口闭合情况、术中及术后并发症。手术后随访时间3个月及以上。结果手术时间8.13±1.47(范围:5.38-11.75)分钟,手术结束时切口闭合好,无需缝合,无术中并发症。1眼因晶体核硬改为超声乳化晶体吸除,其余29眼均由25G玻璃体切割手术系统完成手术。2眼(6.7%)术后一过性眼压升高,药物控制并停药后眼压正常。随访时平均眼压与术前平均眼压相比差异无统计学意义。所有患儿术后前房形成好,前房反应轻微。2眼(6.7%)瞳孔点状部分后粘连,其余患者无后粘连。2眼(6.7%)因中央视轴区混浊发生再次手术。结论 25G玻璃体切割手术系统经角膜切口行晶状体切除联合前部玻璃体切割术治疗婴儿先天性白内障具有良好临床效果。
Objective To investigate the effect and safety of 25G vitrectomy system for the treatment of congenital cataract in infants with corneal incision. Methods The clinical data of 15 cases (30 eyes) treated with 25G vitrectomy system by corneal incision underwent anterior capsulotomy, lensectomy, posterior capsular ring resection and anterior vitrectomy for congenital cataract in infants were retrospectively analyzed. Time, incision closure, intraoperative and postoperative complications. The follow-up time after operation was 3 months and above. Results The operation time was 8.13 ± 1.47 (range: 5.38-11.75) minutes. At the end of the operation, the incision closed well without suturing and no intraoperative complications occurred. One eye due to hard core crystal changed to phacoemulsification crystal suction, the remaining 29 were completed by the 25G vitrectomy surgery system. 2 eyes (6.7%) postoperative transient intraocular pressure increased, the drug control and withdrawal of normal IOP. The average intraocular pressure at follow-up and preoperative average intraocular pressure compared with no significant difference. All children with anterior chamber formation is good, anterior chamber reaction was mild. 2 eyes (6.7%) pupil punctate part of the adhesion, the remaining patients without post-adhesion. Two eyes (6.7%) underwent reoperation due to opacification of the central optic axis. Conclusion 25G vitrectomy system via corneal incision line with anterior vitrectomy for the treatment of congenital cataract in infants has a good clinical effect.