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目的探讨先天性白内障超声乳化吸出或超声乳化吸出联合人工晶体植入,同时进行后囊连续环形撕囊术的手术疗效。方法对白内障超声乳化吸出联合后囊连续环形撕囊术20例29眼,超声乳化吸出联合丙烯酸酯(Acrysof)折叠式IOL植入同时进行后囊连续环形撕囊术15例18眼进行回顾性研究。随访6~18个月观察术后视力、视轴混浊情况、前房反应、虹膜后粘连、人工晶体夹持及眼底情况。结果脱盲率为90%,脱残率67%,4%IOL后出现纤维膜,6%无晶体眼及4%植入IOL眼后囊边缘出现珍珠样的上皮组织增生,植入IOL组6%出现虹膜后粘连,没有出现虹膜夹持、黄斑囊样水肿和视网膜脱离。结论先天性白内障超声乳化吸出或超声乳化吸出联合Acrysof折叠式IOL植入同时进行后囊连续环形撕囊术,以手术切口小,组织损伤小、负压吸引最大限度清除残留的皮质和晶状体上皮细胞,一期PCCC使后囊保留了晶状体上皮细胞无法移行的区域,手术疗效显著,术后并发症减少。手术的远期效果有待进一步研究。
Objective To investigate the surgical treatment of congenital cataract phacoemulsification or phacoemulsification combined with intraocular lens implantation and posterior continuous curvilinear capsulotomy. Methods A retrospective study was performed on 20 cases (29 eyes) of cataract combined with phacoemulsification combined with posterior capsulotomy and 15 cases (18 eyes) of posterior continuous curvilinear capsulotomy combined with phacoemulsification and Acrysof foldable IOL implantation . All the patients were followed up for 6-18 months. Visual acuity, opacity of the optic axis, anterior chamber reaction, posterior iridia, intraocular lens (IOL) clamping and fundus were observed. Results Blindness was 90%, disability rate was 67%. After 4% IOL, there was fibrous membrane, 6% aphakia and 4% Appear iris adhesions, there is no iris clamping, cystoid macular edema and retinal detachment. Conclusions Congenital cataract phacoemulsification or phacoemulsification combined with Acrysof foldable IOL implantation combined with posterior continuous curvilinear capsulotomy with small incision, less tissue damage and negative pressure to minimize the residual cortical and lens epithelial cells , A PCCC posterior capsule retains the lens epithelial cells can not migrate the area, significant effect of surgery, postoperative complications decreased. The long-term effect of surgery needs further study.