Meyner E M
Klin Monbl Augenheilkd. 1978 Nov;173(5):737-43.
In view of contradicting opinions regarding the chances by operations of unilateral congenital cataracts, we tested 97 children systematically since 1966. We especially tried to find out which functional meaning can be given to the operation and the following occlusion treatment. 64 children were operated, of these 22 in their 1. and 2. year of life, and an attempt of occlusion therapy followed. By 31 children test results were insufficient due mainly to the lack of cooperation of the parents who did not completely carry out the recommended therapy. In 2 patients the visual acuity improved clearly with central fixation. 6 children had a subjective, reliable orientation although their visual acuity lied under 0,2 and no central fixation was achieved. By the visual acuity and fixation test, they did not however differenciate from other children, who showed no improvement subjectively. The occlusion therapy was broken up by 15 children because of subjective discouragement and no signs of progression concerning the therapy. In retrospect serious operative complications within the observation time were not noted. Every type of cataract requires individual surgical techniques. Obviously, in such cases the measured visual acuity is not the appropriate criteria to judge the functional performance of the eye.
鉴于对于单侧先天性白内障手术成功率存在相互矛盾的观点,自1966年以来,我们对97名儿童进行了系统测试。我们特别试图弄清楚手术及后续遮盖治疗能带来何种功能意义。64名儿童接受了手术,其中22名在1岁和2岁时接受手术,随后尝试进行遮盖治疗。31名儿童的测试结果不充分,主要原因是家长缺乏配合,未完全执行推荐的治疗方法。2名患者的视力通过中心注视明显提高。6名儿童虽然视力低于0.2且未实现中心注视,但具有主观可靠的定向能力。然而,通过视力和注视测试,他们与其他主观上没有改善的儿童并无差异。15名儿童因主观上感到气馁且治疗无进展迹象而中断了遮盖治疗。回顾观察期内未发现严重的手术并发症。每种类型的白内障都需要个体化的手术技术。显然,在这种情况下,所测得的视力并非判断眼睛功能表现的合适标准。