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目的探讨双撕囊联合前部玻璃体切除术在婴幼儿先天性白内障手术中的临床应用效果。方法对72例(118眼)年龄15天~4岁的先天性白内障施行白内障超声乳化吸除术,2岁以上62眼植入人工晶体。其中Ⅰ组28例(46眼)单纯行白内障超声乳化吸除术,Ⅱ组44例(72眼)施行白内障超声乳化吸除术联合前囊及后囊膜连续环形撕囊术及前部玻璃体切除术。随访时间最长为66个月,最短为4个月。结果术后随访103眼,矫正视力0.05~0.1者,Ⅰ组3眼(6.52%),Ⅱ组0眼(0%);矫正视力0.1~0.2者,Ⅰ组10眼(21.74%),Ⅱ组1眼(1.75%);矫正视力0.3~0.4者,Ⅰ组16眼(34.78%),Ⅱ组20眼(35.09%);矫正视力≥0.5者,Ⅰ组17眼(36.96%),Ⅱ组36眼(63.16%);两组比较差异有统计学意义(χ~2=4.18,P<0.05)。后囊浑浊≥3级者Ⅰ组11眼(23.92%),Ⅱ组4眼(5.56%)。两组比较差异有统计学意义(χ~2=5.36,P<0.05)。结论婴幼儿先天性白内障术中行双撕囊联合前部玻璃体切除术,能明显降低后发障的发生率,有助于患儿术后视功能的重建。
Objective To investigate the clinical effect of double capsulorhexis combined with anterior vitrectomy in congenital cataract surgery in infants. Methods 72 cases (118 eyes) of congenital cataracts aged 15 days to 4 years underwent phacoemulsification and 62 eyes aged above 2 years old were implanted intraocular lens. In group Ⅰ, 28 cases (46 eyes) were treated with simple phacoemulsification, and 44 cases (72 eyes) in group Ⅱ underwent phacoemulsification combined with anterior capsule and posterior capsular continuous curvilinear capsulotomy and anterior vitrectomy Surgery. The longest follow-up was 66 months, the shortest was 4 months. Results There were 103 eyes with corrected visual acuity (0.05 ~ 0.1), 3 eyes (6.52%) in group Ⅰ, 0 eyes (0%) in group Ⅱ, 10 eyes (21.74%) in group Ⅰ, 1 eyes (1.75%), corrected visual acuity 0.3 ~ 0.4, group Ⅰ 16 eyes (34.78%), group Ⅱ 20 eyes 35.09%, corrected visual acuity ≥ 0.5, group Ⅰ 17 eyes (36.96% Eyes (63.16%). There was significant difference between the two groups (χ ~ 2 = 4.18, P <0.05). Posterior capsular opacity ≥ grade 3 in group I, 11 eyes (23.92%), group Ⅱ, 4 eyes (5.56%). The difference between the two groups was statistically significant (χ ~ 2 = 5.36, P <0.05). Conclusions In pediatric congenital cataract surgery, double capsulorhexis combined with anterior vitrectomy can significantly reduce the incidence of post-ocular obstacle and contribute to the reconstruction of postoperative visual function.