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目的 :评价超声乳化的设备及操作技术在儿童白内障手术中的应用。方法 :对 6 6例 (82眼 ) 3～ 12岁的儿童白内障行白内障摘除及人工晶体植入术 ,术中应用了巩膜隧道切口及连续环形撕囊技术 ,并使用了超声乳化仪器的灌注抽吸系统清除软性晶体核及皮质 ,囊袋内植入人工晶体。结果 :术后矫正视力≥ 0 .5的 2 1眼 (2 5 .6 % ) ,视力在 0 .1～ 0 .4的 35眼 (4 2 .7% ) ,视力 <0 .1的14眼 (17% ) ,欠合作的 12眼 (14.6 % ) ,伴有斜视 12眼 ,眼颤的 5眼。术中前房发生不同程度纤维素性渗出有 2眼 (2 .4% )。术后前房有纤维素性渗出有 6眼 (7.3% )。其中 2眼有明显的膜性物形成 ,主要为外伤性白内障患者。术后随访发现瞳孔明显变形的有 4眼 (4 .9% ) ,其中轻度上移的 2眼 (2 .4% )。后囊膜混浊的 18眼 (2 2 .0 % ) ,其中 2眼需行 YAG激光后囊膜切开术 ,1眼伴人工晶体夹持需行晶体复位术。结论 :超声乳化设备及技术的应用 ,使儿童型白内障手术的手术合并症较传统的手术方法明显减少 ,为开展儿童白内障手术带来新的希望。
Objective: To evaluate the application of phacoemulsification equipment and operation technique in cataract surgery in children. Methods: Cataract extraction and intraocular lens implantation were performed in 66 children (82 eyes) with cataract from 3 to 12 years old. Scleral tunnel incision and continuous circular capsulorhexis technique were used in this study. The perfusion pumping of phacoemulsification instrument Suction system to clear the soft crystal nucleus and cortex, intraocular lens implantation. RESULTS: Twenty-one eyes (25.6%) had corrected visual acuity of 0.5 or more, 35 eyes (4.2%) had visual acuity of 0.1-1.4, visual acuity of <0.1 (17%), 12 eyes (14.6%) who owed cooperation, 12 eyes with strabismus and 5 eyes with nystagmus. Intraoperative anterior chamber fibrosis occurs in varying degrees of exudate in 2 eyes (2.4%). Postoperative anterior chamber there are 6 cases of cellulose exudate (7.3%). Two of them had obvious membranous formation, mainly for traumatic cataract patients. There were 4 eyes (4. 9%) with obvious pupil deformity and 2 eyes (2 .4%) slightly upturned. Posterior capsule opacification in 18 eyes (22.0%), of which 2 patients underwent YAG laser posterior capsulotomy, 1 eye with intraocular lens grafting need to undergo a crystal reduction. Conclusion: The application of phacoemulsification equipment and techniques has significantly reduced the number of surgical complications in children with cataract surgery compared with the traditional methods of operation, bringing new hope for the development of cataract surgery in children.