[关键词]
[摘要]
目的:观察23G玻璃体切除系统在儿童先天性白内障手术中的应用效果。
方法:纳入2017-11/2018-12海南医学院第一附属医院眼科收治的3~8岁先天性白内障患儿11例19眼,应用23G玻璃体切除系统从角巩膜缘切口进入前房,行前囊膜环形切除、白内障抽吸、人工晶状体植入、后囊膜环形切除联合前段玻璃体切除术,术后随访3~24mo,观察患儿视力、眼压及眼部情况。
结果:所有患儿均术程顺利。术中前房稳定,晶状体囊膜环形切除精准,人工晶状体Ⅰ期植入。术后视力均较术前明显提高。术后仅1例患儿眼压高于25mmHg,予以药物降眼压后控制在正常范围。随访期间所有患儿角膜透明,无前房出血,无瞳孔变形,人工晶状体居中、正位,视轴区透明,无明显并发症发生。
结论:23G玻璃体切除系统用于儿童先天性白内障术中创伤小,切除晶状体囊膜精准,术后反应轻、并发症少,手术安全有效。
[Key word]
[Abstract]
AIM: To investigate the therapeutic effect of 23G vitrectomy system used in children with congenital cataracts.
METHODS: From November 2017 to December 2018, 11 children(19 eyes)aged 3-8 years old with congenital cataract were recruited in the Department of Ophthalmology, the First Affiliated Hospital of Hainan Medical University. 23G vitrectomy instruments were used to enter the anterior chamber through the incision at the corneal limbus, and complete ring resection of anterior capsule, cataract aspiration, intraocular lens implantation, and ring resection of posterior capsule combined with anterior vitrectomy. The visual acuity, intraocular pressure and ocular conditions of the children were observed during 3-24mo of follow-up.
RESULTS: All the surgeries were uneventful. During the surgeries, the anterior chambers were stable, the ring resections of lens capsules were accurate, and the IOLs were implanted at the 1st phase. The postoperative visual acuity was significantly improved compared with that before surgery. Only 1 patient had intraocular pressure higher than 25mmHg after surgery, which was controlled within the normal range after medication was given. During the follow-up period, all the children had clear corneas, no anterior chamber hemorrhage, no pupil deformation, the intraocular lens was in the center and the right position, the optic axis was transparent, and no obvious complications occurred.
CONCLUSION: The 23G vitrectomy system is safe and effective for the surgery of congenital cataract, it can achieve little trauma, accurate lens capsule resection, little postoperative reaction and few complications.
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[基金项目]
国家自然科学基金项目(No.81860172); 海南省科技厅重点研发项目(No.ZDYF2019184)