上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (10): 1208-.doi: 10.3969/j.issn.1674-8115.2018.10.013

• 论著·临床研究 • 上一篇    下一篇

单眼先天性白内障患儿术后无晶状体眼采用不同矫正方式的视功能及眼部并发症评估

陈珺珏 1，孙平 2，韦严 1，亢晓丽 1   

  1. 1. 上海交通大学医学院附属新华医院眼科，上海 200092；2. 复旦大学附属眼耳鼻喉科医院眼科，上海 200031
  • 出版日期:2018-10-28 发布日期:2018-11-18
  • 通讯作者: 亢晓丽，电子信箱：kangxiaoli@xinhuamed.com.cn。
  • 作者简介:陈珺珏 (1991—)，女，住院医师，硕士；电子信箱： 787391961@qq.com。
  • 基金资助:
    上海市卫生和计划生育委员会重点项目（201440037）

Evaluation of visual function and adverse effects of different correction methods in the infants with monocular aphakia after congenital cataract surgery

CHEN Jun-jue1, SUN Ping2, WEI Yan1, KANG Xiao-li1   

  1. 1. Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; 2. Department of Ophthalmology, Eye & Ent Hospital, Fudan University, Shanghai 200031, China
  • Online:2018-10-28 Published:2018-11-18
  • Supported by:
    Major Program of Health and Family Planning Commission of Shanghai，201440037

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摘要： 目的 ·分析单眼先天性白内障患儿术后无晶状体眼佩戴硬性透气性角膜接触镜（rigid gas permeable contact len，RGPCL）及一期植入人工晶状体（ intraocular len，IOL）患儿的视功能及眼部相关并发症。方法 ·回顾性分析了单眼先天性白内障患儿术后无晶状体眼佩戴 RGPCL及一期植入 IOL患儿的视力、眼位、眼球震颤、遮盖依从性和角膜接触镜相关并发症及不良事件。结果 ·共 60例患者入组。组 1为单眼无晶状体眼患儿佩戴 RGPCL 20例，组 2为单眼先天性白内障一期植入 IOL患者 40例。组 1患者的视力、眼位均显著改善（均 P<0.05），组 1及组 2患者终末视力和终末眼位差异无统计学意义，组 1的眼球震颤缓解率高于组 2。遮盖健眼依从性好的患者较依从性差的患者术后视力恢复更好（ P<0.05）。组 1患者未出现影响视力的眼部病理改变，组 2患者较组 1患者出现更多的眼部并发症。结论 ·佩戴 RGPCL是一种对于单眼白内障术后无晶状体眼的安全、有效的光学矫正方式，尤其对 2岁以下不适宜植入 IOL的患者，可与一期植入 IOL达到相似的矫正效果，且较少出现眼部并发症。

关键词: 硬性透气性角膜接触镜, 先天性白内障, 单眼, 无晶状体, 人工晶状体

Abstract:

Objective · To analyze the changes in visual function and adverse effects of wearing rigid gas permeable contact lens (RGPCL) and primary intraocular lens (IOL) implantation in the infants with monocular aphakia after congenital cataract surgery. Methods · The pre- and postoperative visual acuity, strabismus, nystagmus, adherence to patching and adverse events of the patients with unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation were analyzed retrospectively. RGPCLs were used to correct aphakia who did not receive IOLs. Results · All of 60 patients were included in this study. Twenty patients with unilateral aphakia used RGPCLs (group 1). Forty patients were implanted with IOLs primarily (group 2). In group 1, there was obvious improvement in visual acuity and strabismus (P<0.05). There was no statistic difference in visual acuity and strabismus between group 1 and group 2 finally. Nystagmus remission rate in group 1 was higher than that in group 2. The patients with adherence to patching had better visual acuity after operation than those without (P<0.05). All of the patients in group 1 had no ocular disease that affect visual acuity. More adverse events happened in group 2. Conclusion · Wearing RGPCL is a safe and effective optical correction method for the patients with monocular aphakia after congenital cataract surgery, especially for the patients below 2 years old who are not suifor IOL implantation. RGPCL has similar visual correction effect on the patients with primary IOL implantation, but it is accompaniedless adverse events.

Key words: rigid gas permeable contact len, congenital cataract, monocular, aphakia, intraocular len

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