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目的 探讨儿童先天性白内障手术治疗的临床疗效及术后防治弱视的重要性。方法 对我院 6年来共收治先天性白内障患儿 5 2例 ( 74眼 ) ,分别行白内障囊外摘除 (ECCE组 ) 2 5例 ( 3 4眼 )、及白内障囊外摘除人工晶体植入术联合后囊切开及视轴中央前段玻璃体切除术 (ECCE +VAC组 ) 2 7例 ( 3 6眼 )。对术后随访 2～ 5年的远期视力及影响远期视力的原因等进行了回顾性分析。统计学处理采用 χ2 检验。结果 手术后脱盲率为 73 .3 %、脱残率为 5 0 .7%,经弱视治疗后提高为 86.7%和 76.8%。单眼病例在术后效果及弱视治疗后疗效均较双眼病例差 ,两者比较差异有显著性 ,P <0 .0 5。两种手术方式比较也有非常显著性差异 ,P <0 .0 1。结论 提倡儿童先天性白内障早期诊断、早期手术。采用白内障囊外摘除并植入人工晶体同时行Ⅰ期后囊切开联合前段玻璃体切除术为有效的治疗方法。 3岁左右儿童植入人工晶体可获得良好视力 ,重建视功能。强调术后随访 ,治疗弱视是保持和巩固远期视力的关键。
Objective To investigate the clinical efficacy of surgical treatment of children with congenital cataract and the importance of postoperative prevention and treatment of amblyopia. Methods A total of 52 cases (74 eyes) of children with congenital cataract were treated in our hospital for 6 years. Twenty-five (34 eyes) of extracapsular cataract extraction (ECCE) and cataract extraction of extracapsular cataract There were 27 cases (36 eyes) with posterior capsulotomy and anterior vitrectomy (ECCE + VAC group). The follow-up of 2 to 5 years of long-term vision and the impact of long-term vision reasons were retrospectively analyzed. Statistical analysis using χ2 test. Results The postoperative blindness rate was 73.3%, the disability rate was 57.7%, and the improvement was 86.7% and 76.8% after amblyopia treatment. The results of monocular cases after surgery and amblyopia were worse than those of both eyes, the difference was significant (P <0.05). There was also a very significant difference between the two surgical methods, P <0.01. Conclusion To promote early diagnosis and early surgery of congenital cataract in children. The use of extracapsular cataract extraction and intraocular lens implantation while posterior capsulotomy combined with anterior vitrectomy as an effective treatment. 3 years old children implanted intraocular lens can get good vision, visual function reconstruction. Emphasize postoperative follow-up, treatment of amblyopia is the key to maintain and consolidate long-term vision.