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目的 探讨儿童白内障摘除联合前段玻璃体切割及人工晶体植入的临床疗效。方法 41例 (5 9只眼 )儿童先天性白内障及外伤性白内障施行现代囊外摘除联合前段玻璃体切割 ,对 3岁以上儿童 3 8例 (5 3只眼 )同期成功植入后房型人工晶体。结果 3岁以上儿童术后裸眼视力≥ 0 3者先天性白内障 2 5只眼 (69 4% ) ,外伤性白内障 1 4只眼 (82 4% )。术后 ,先天性白内障 1只眼发生后囊混浊 ;外伤性白内障 3只眼轻度瞳孔上移 ,1只眼轻度晶体偏位。影响术后视力提高的主要原因是先天性白内障的重度弱视和外伤性白内障的角膜瘢痕。结论 儿童白内障后囊膜切开联合前段玻璃体切割是防止术后并发障的有效方法。
Objective To investigate the clinical efficacy of combined anterior vitrectomy and intraocular lens implantation in children with cataract extraction. Methods 41 cases (59 eyes) of children with congenital cataract and traumatic cataract were treated with modern extracapsular cataract extraction combined with anterior vitrectomy. The posterior chamber intraocular lens (IOL) was successfully implanted in 38 cases (53 eyes) of children over 3 years old. Results The postoperative uncorrected visual acuity ≥0 3 in children over 3 years old was 25 eyes (69 4%) of congenital cataract and 14 eyes (82 4%) of traumatic cataract. Postoperatively, posterior capsular opacification occurred in one eye of congenital cataract; mild pupil migration was observed in three eyes of traumatic cataract and slight crystallographic deviation of one eye. The main reason for the increase of postoperative visual acuity is severe amblyopia of congenital cataract and corneal scar of traumatic cataract. Conclusion Posterior capsulotomy combined with anterior vitrectomy in children is an effective method to prevent postoperative complications.