Paikos P, Fotopoulou M, Papathanassiou M, Choreftaki P, Spyropoulos G
Ophthalmology Department, Agia Sofia Children's Hospital, Athens, Greece.
J Pediatr Ophthalmol Strabismus. 2001 Jan-Feb;38(1):16-20. doi: 10.3928/0191-3913-20010101-07.
To report the technique and postoperative results of cataract surgery in children with uveitis.
Between 1988 and 1998, nine children (age range: 2.5-11 years) who developed secondary uveitic cataract and underwent cataract extraction were studied retrospectively. Seven children had juvenile rheumatoid arthritis and two had chronic anterior uveitis of unknown etiology. The surgical technique was lensectomy and wide anterior vitrectomy with limbal approach, lysis of anterior synechiae and in some cases, peripheral iridectomy. Postoperative aphakia was corrected with soft contact lenses in all patients. Follow-up ranged from 6 months to 6 years.
Postoperatively, visual acuity in all patients improved and final visual acuity ranged from 20/70 to 20/25. Significant intraoperative complications did not occcur in any patient. One boy with juvenile rheumatoid arthritis developed cystoid macular edema 1 month postoperatively, which was successfully managed. He also developed hypertonia 1 year later, which was also successfully managed. Seven of the nine children had fewer and milder relapses of uveitis after surgery.
Cataract surgery, using the lensectomy-vitrectomy technique in children with uveitis, is a safe technique with a relatively small percentage of postoperative complications and good functional results.
报告葡萄膜炎患儿白内障手术的技术及术后结果。
回顾性研究1988年至1998年间9例发生继发性葡萄膜炎性白内障并接受白内障摘除术的儿童（年龄范围：2.5 - 11岁）。7例患儿患有幼年型类风湿关节炎，2例患有病因不明的慢性前葡萄膜炎。手术技术为晶状体切除术及经角膜缘入路的广泛前部玻璃体切除术、前粘连松解术，部分病例行周边虹膜切除术。所有患者术后无晶状体状态均采用软性接触镜矫正。随访时间为6个月至6年。
术后所有患者视力均有提高，最终视力范围为20/70至20/25。所有患者术中均未发生严重并发症。1例患有幼年型类风湿关节炎的男孩术后1个月发生黄斑囊样水肿，经成功治疗。1年后他还出现了高眼压，也成功得到了治疗。9例患儿中有7例术后葡萄膜炎复发次数减少且症状减轻。
对于葡萄膜炎患儿，采用晶状体切除 - 玻璃体切除技术进行白内障手术是一种安全的技术，术后并发症发生率相对较低，功能效果良好。
