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后房型人工晶状体:小儿白内障患者的长期结果

Posterior chamber intraocular lenses: long-term results in pediatric cataract patients.

作者信息

Crouch E R, Pressman S H, Crouch E R

机构信息

Department of Ophthalmology, Eastern Virginia Medical School, Norfolk 23502, USA.

出版信息

J Pediatr Ophthalmol Strabismus. 1995 Jul-Aug;32(4):210-8. doi: 10.3928/0191-3913-19950701-03.

Abstract

Major problems in pediatric cataract patients include noncompliance with contact lenses resulting in amblyopia. Advances in intraocular cataract surgery have provided a better environment to perform intraocular lens (IOL) implantation in children. We prospectively analyzed the results of 34 consecutive pediatric patients who underwent cataract removal and insertion of an IOL. Operative technique performed was posterior scleral beveled or frown incision and IOL endocapsular fixation. Subgroups included 10 eyes with traumatic cataract, and 24 eyes with developmental cataracts. Six patients had bilateral IOLs. Data presented in each subgroup included initial and final visual acuity, age, sex, type of cataract, A and B scan biometry, early and late postoperative complications, time of YAG capsulotomy, postoperative refractive correction, and state of binocular vision. Preoperative visual acuity ranged from 20/70 to light perception. The success rate for postoperative visual acuity of 20/40 or better occurred in 29 of 34 eyes, or 85.3%. In the traumatic cataracts, 8 of 10 eyes (80%) obtained 20/40 vision or better. In developmental cataracts, 21 of 24 eyes (88%) achieved visual acuity of 20/40 or better. Amblyopia (three patients) or macular scar (two patients) accounted for reduced visual acuity in the five eyes with vision less than 20/40. Early complications included posterior synechiae and lens deposits. The primary late complication was opacification of the posterior capsule in 18 of 34 eyes. The average time for YAG capsulotomy post-cataract removal was 17 months. None of the 28 patients (34 eyes) developed glaucoma, IOL dislocation, or other significant postoperative problems related to IOL insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

小儿白内障患者的主要问题包括不遵守隐形眼镜佩戴规定导致弱视。眼内白内障手术的进展为在儿童中进行人工晶状体(IOL)植入提供了更好的环境。我们前瞻性分析了34例连续接受白内障摘除和IOL植入的小儿患者的结果。所采用的手术技术为后巩膜斜切或皱眉切口以及IOL囊内固定。亚组包括10只外伤性白内障眼和24只发育性白内障眼。6例患者植入了双侧IOL。每个亚组呈现的数据包括初始和最终视力、年龄、性别、白内障类型、A超和B超生物测量、术后早期和晚期并发症、YAG激光切开术时间、术后屈光矫正以及双眼视状态。术前视力范围为20/70至光感。34只眼中有29只(85.3%)术后视力达到20/40或更好。在外伤性白内障中,10只眼中有8只(80%)视力达到20/40或更好。在发育性白内障中,24只眼中有21只(88%)视力达到20/40或更好。视力低于20/40的5只眼中,弱视(3例患者)或黄斑瘢痕(2例患者)导致视力下降。早期并发症包括后粘连和晶状体沉着物。主要的晚期并发症是34只眼中有18只出现后囊膜混浊。白内障摘除后YAG激光切开术的平均时间为17个月。28例患者(34只眼)均未发生青光眼、IOL脱位或其他与IOL植入相关的严重术后问题。(摘要截短至250字)

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