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目的:分析儿童白内障人工晶状体植入术后双眼视功能恢复情况。方法:选择我院眼科收治的白内障人工晶状体植入术后患儿50例,根据白内障发病原因分为先天性单眼白内障组18例、先天性双眼白内障组9例和外伤性单眼白内障组23例。比较各组手术前后最佳矫正视力等级(光感~0.1、0.1~0.4和0.5~1.0)分布情况,观察所有病例双眼视功能(三维视功能、周边融合能力、近立体视力)及术后并发症发生情况。结果:(1)手术前,先天性单眼白内障组、先天性双眼白内障组和外伤性单眼白内障组视力水平均集中在光感~0.1和0.1~0.4;手术后,3组视力水平均较手术前有不同程度提升,主要分布在0.1~0.4,其中,先天性单眼白内障组和外伤性单眼白内障组光感~0.1比例显著或非常显著降低(P<0.05,P<0.01)。(2)白内障人工晶状体植入术后患儿50例中,斜视10例,同时视8例,融合能力和立体能力各7例。(3)白内障人工晶状体植入术后患儿50例中,发生不同程度眼角膜水肿5例,其中3例未经特殊处理自行恢复;瞳孔有膜性物形成1例,于术后10天完全溶解;出现不同程度前房渗出1例,经局部使用阿托品散瞳后好转。无一例发生严重并发症。结论:儿童白内障人工晶状体植入术后双眼视功能恢复良好。
Objective: To analyze the recovery of binocular vision after implantation of cataract in children. Methods: Fifty children with cataract after intraocular lens implantation were selected. According to the causes of cataract, there were 18 cases of congenital monocular cataract, 9 cases of congenital binocular cataract and 23 cases of traumatic monocular cataract. The distribution of best corrected visual acuity (light sensitivities ~ 0.1, 0.1 ~ 0.4 and 0.5 ~ 1.0) before and after operation in each group was compared. The binocular visual function (3D visual function, peripheral fusion ability, near stereovision) and postoperative complications Occurrence of disease. Results: (1) Prior to surgery, the visual acuity levels of congenital monocular cataract, congenital binocular cataract and traumatic monocular cataract were all in the light sensitivities of 0.1 and 0.1-0.4. After the operation, the visual acuity of the three groups was significantly higher than that before surgery (P <0.05, P <0.01). There was a significant or very significant decrease (P <0.05) in the proportion of light to 0.1 in congenital monocular cataract and traumatic monocular cataract. (2) 50 cases of children with cataract after intraocular lens implantation, strabismus in 10 cases, at the same time, as 8 cases, fusion ability and stereoscopic ability in 7 cases. (3) In 50 cases of children with cataract after intraocular lens implantation, different degrees of corneal edema occurred in 5 cases, of which 3 cases recovered without special treatment; pupil membranous formation in 1 case, complete 10 days after surgery Dissolution; there were different degrees of anterior chamber exudation in 1 case, after local use of atropine mydriasis improved. No case of serious complications. Conclusion: The binocular visual function recovered well after cataract extraction in children.