本文選題：先天性白內(nèi)障　切入點(diǎn)：人工晶體植入　出處：《廣西醫(yī)科大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：觀察比較2歲內(nèi)先天性白內(nèi)障患兒I期和II期植入人工晶體的結(jié)果。 方法：回顧性觀察38例(50眼)年齡小于2歲的先天性白內(nèi)障患兒,其中A組16例(20眼)2個月到24個月的先天性白內(nèi)障患兒行白內(nèi)障抽吸+人工晶體I期后房植入+后囊膜環(huán)形撕囊(PCCC)+前段玻璃體切割術(shù)(AV)。B組22例(30眼)2個月到24個月的先天性白內(nèi)障患兒行白內(nèi)障抽吸+后囊膜環(huán)形撕囊(PCCC)+前段玻璃體切割術(shù)(AV),2歲后再行II期人工晶體后房植入術(shù)。根據(jù)出院復(fù)查門診病歷記錄和電話隨訪比較觀察兩組術(shù)后并發(fā)癥和視力恢復(fù)情況,時間均為術(shù)后12月到36個月。 結(jié)果：A組患兒情況是：無明顯并發(fā)癥的有12眼,8眼合并有以下1-3種并發(fā)癥：瞳孔不規(guī)則或后粘連共5眼；后發(fā)障的有3眼；人工晶體前膜的有2眼；外斜視的有3眼；人工晶體偏位或夾持的有1眼；眼球震顫出現(xiàn)或加重的有4眼：繼發(fā)青光眼的有1眼。患兒3到4歲視力情況：有14眼視力大于0.1(占總眼數(shù)70%),有5眼視力小于0.1,1眼視力不配合。B組患兒情況是：無明顯并發(fā)癥的有8眼,22眼合并有以下1-3種并發(fā)癥：瞳孔不規(guī)則或后粘連共22眼；后發(fā)障的有4眼；人工晶體前膜的有3眼；斜視加重的有4眼；人工晶體偏位或夾持的有12眼；眼球震顫出現(xiàn)或加重的有5眼；繼發(fā)青光眼的有3眼�；純�3到4歲視力情況：有13眼視力大于0.1(占總眼數(shù)43%),有16眼視力小于0.1,1眼視力不配合。結(jié)果的統(tǒng)計學(xué)分析,瞳孔不規(guī)則或虹膜部分后粘連：A組有5眼,B組有22眼,x2=11.286,P=0.001兩組間差異有統(tǒng)計學(xué)意義(P0.01),A組發(fā)生此并發(fā)癥少于B組.兩組患兒術(shù)后其他并發(fā)癥差異均無統(tǒng)計學(xué)意義(P0.05)。3歲后視力改善統(tǒng)計值x2=3.884,P=0.049兩組間差異有統(tǒng)計學(xué)意義(P0.05),A組視力好于B組。 結(jié)論：通過兩組患兒術(shù)后的臨床觀察對比,在治療方案上,2個月到24個月的先天性白內(nèi)障患兒行白內(nèi)障抽吸+人工晶體I期后房植入+后囊膜環(huán)形撕囊(PCCC)+前段玻璃體切割術(shù)(AV),可有效恢復(fù)屈光間質(zhì)透明,減少屈光不正的程度,術(shù)后并發(fā)癥與II期人工晶體植入對比無明顯增多,術(shù)后視力恢復(fù)更好,對遠(yuǎn)期視力情況還需要長時間觀察。
[Abstract]:Objective: to observe and compare the results of intraocular lens implantation in stage I and II of children with congenital cataract within 2 years old. Methods: 38 cases (50 eyes) of congenital cataract, whose age was less than 2 years old, were retrospectively observed. Group A (16 cases, 20 eyes) with congenital cataract for 2 months to 24 months underwent posterior chamber implantation with posterior chamber implantation of posterior capsular annular capsulorhexis (PCCC) anterior segment vitrectomy for 2 to 24 months. Group B (22 cases, 30 eyes) received anterior vitrectomy for posterior capsular annular capsulorhexis (PCCC) for 2 months to 24 months. The anterior segment vitrectomy of posterior capsular annular capsulorhexis (PCCCC) was performed in children with congenital cataract after 2 years of age. Phase II IOL posterior chamber implantation was performed after 2 years of age. A comparative study was made according to the medical records of outpatient outpatient and telephone follow-up. The postoperative complications and visual acuity were observed in both groups. The time was from December to 36 months after operation. Results in group A, 12 eyes (8 eyes) without obvious complications were complicated with the following 1-3 complications: 5 eyes with irregular pupil or posterior adhesion, 3 eyes with posterior defect, 2 eyes with anterior membrane of intraocular lens, 3 eyes with exotropia, 3 eyes with posterior synechia, 3 eyes with posterior synechia, 3 eyes with posterior myopia, 3 eyes with posterior conglutination, 3 eyes with posterior conglutination, 3 eyes with intraocular lens membrane. Intraocular lens misalignment or clamping of 1 eye; There were 4 eyes with nystagmus or aggravation: 1 eye with secondary glaucoma. Visual acuity of children aged 3 to 4 years: 14 eyes with visual acuity greater than 0.1 (accounting for 70 eyes, 5 eyes with visual acuity less than 0.1%). 8 eyes (22 eyes) without obvious complications were complicated with the following 1-3 kinds of complications: 22 eyes had irregular pupil or posterior adhesions; There were 4 eyes with posterior impairment, 3 eyes with anterior membrane of intraocular lens, 4 eyes with aggravated strabismus, 12 eyes with IOL deviation or clamping, 5 eyes with nystagmus and 5 eyes with severe nystagmus. There were 3 eyes with secondary glaucoma. Visual acuity of children aged 3 to 4 years: 13 eyes with visual acuity greater than 0.1 (accounting for 43 eyes and 16 eyes with visual acuity less than 0.1%). There were 22 eyes with irregular pupil or iris posterior adhesion in group B, 22 eyes in group B had a significant difference between group A and group B. the complications in group A were less than those in group B. there was no significant difference in other complications between the two groups (P 0.05.3 years old). The visual acuity of group A was better than that of group B. There was a significant difference between the two groups in the statistical value of visual acuity improvement (x2) 3.884% P0. 049. The visual acuity of group A was better than that of group B. Conclusion: through the clinical observation and comparison of two groups of children after operation, In the treatment scheme, the anterior segment vitrectomy of posterior chamber implantation of posterior capsular annular capsulorhexis (PCCCCC) was performed in children with congenital cataract from 2 months to 24 months after cataract aspiration, which could effectively restore the transparency of refractive stroma. To reduce the degree of ametropia, the postoperative complications were not significantly increased compared with those of stage II IOL implantation, the postoperative visual acuity recovered better, and the long-term visual acuity still needed to be observed for a long time.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R776.1

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本文編號：1603016