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小儿白内障手术中采用光学捕获和前房内注入肝素的原发性后囊连续环形撕囊术

Primary posterior capsulorhexis with optic capture and intracameral heparin in paediatric cataract surgery.

作者信息

Dada T, Dada V K, Sharma N, Vajpayee R B

机构信息

R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.

出版信息

Clin Exp Ophthalmol. 2000 Oct;28(5):361-3. doi: 10.1046/j.1442-9071.2000.00339.x.

Abstract

PURPOSE

To study the efficacy of using a primary posterior capsulorhexis with optic capture and intracameral heparin in preventing secondary posterior capsule opacification, in paediatric cataract surgery.

METHODS

Primary posterior capsulorhexis and optic capture with a heparin-coated intraocular lens (IOL) was performed after lens aspiration in 14 cataractous eyes of 13 children (group I). Ten international units of heparin were added in the irrigating solution. The results were compared with 14 eyes of 11 children who underwent a similar surgical procedure but without a posterior capsulorhexis (group 2).

RESULTS

The mean age of the patients in group I was 4.2+/-1.5 years (mean +/- SD) and in group 2 was 4.5+/-1.8 years (range 3-6 years in both the groups). The mean duration of follow up was 36+/-6.4 months in group I and 38+/-8.1 months in group 2. A best corrected visual acuity of 6/24 or better was achieved in 12 eyes in group I and II eyes in group 2. The visual axis remained clear in all the eyes in group I, while 8 eyes (57.14%) in group 2 developed posterior capsule opacification (P = 0.0034) which required a neodymium:yttrium-aluminum-garnet laser capsulotomy.

CONCLUSIONS

Lens aspiration using intracameral heparin, combined with primary posterior capsulorhexis and optic capture of a heparin-coated IOL, is a useful technique to prevent secondary visual axis opacification in paediatric cataracts.

摘要

目的

研究在儿童白内障手术中,采用原发性后囊撕开联合光学部夹持及前房内注入肝素预防后发性白内障的疗效。

方法

对13例儿童的14只白内障眼进行晶状体吸出术后,行原发性后囊撕开及肝素涂层人工晶状体(IOL)的光学部夹持(第一组)。在冲洗液中加入10国际单位的肝素。将结果与11例儿童的14只眼进行比较,这些儿童接受了类似的手术操作,但未进行后囊撕开(第二组)。

结果

第一组患者的平均年龄为4.2±1.5岁(平均值±标准差),第二组为4.5±1.8岁(两组范围均为3 - 6岁)。第一组的平均随访时间为36±6.4个月,第二组为38±8.1个月。第一组12只眼和第二组11只眼的最佳矫正视力达到6/24或更好。第一组所有眼的视轴均保持清晰,而第二组8只眼(57.14%)发生了后囊混浊(P = 0.0034),需要进行钕:钇铝石榴石激光晶状体切开术。

结论

前房内注入肝素联合晶状体吸出,同时行原发性后囊撕开及肝素涂层IOL的光学部夹持,是预防儿童白内障继发性视轴混浊的有效技术。

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