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目的总结儿童晶状体脱位手术治疗对视觉发育的影响。方法收集1999年7月至2007年11月连续12例23只眼先天性晶状体不全脱位病例,年龄4~13岁,平均7.78岁。分析其手术前后的视力及屈光度变化。手术全部为同期白内障摘除联合人工晶体植入术(10只眼为晶体悬吊、13只眼植入前房型人工晶体)。随访时间3个月以上,平均25.1个月,评价术后视力及屈光度变化趋势。结果术前裸眼视力0.04~0.4,中位数0.1,最好矫正视力0.1~0.8,中位数0.2,16只眼视力低于0.3。屈光度+18D~-18D,15只眼在±10D以上。术后近期裸眼视力0.2~0.6,中位数0.3;随访末期最好矫正视力0.4~1.0,中位数0.7,全部脱残。屈光度1只眼远期发展为-7D,其他等效球镜度均<3D;2只眼散光度>2.5DC。手术后炎症反应轻微,两种人工晶体植入方式在矫正视力及手术后炎症反应和手术并发症发生几率方面均无明显差异。结论及时为晶状体脱位儿童进行手术治疗有利于儿童视觉发育。
Objective To summarize the effects of surgical treatment on visual development in children with lens dislocation. Methods A total of 12 consecutive cases of congenital lens dysplasia in 12 eyes from July 1999 to November 2007 were collected, ranging in age from 4 to 13 years with an average of 7.78 years. Visual acuity and diopter changes before and after surgery were analyzed. All surgically combined cataract extraction combined with intraocular lens implantation (10 eyes were crystal suspension, 13 eyes implanted anterior chamber intraocular lens). Follow-up time of 3 months or more, an average of 25.1 months, assessment of postoperative visual acuity and diopter trends. Results preoperative uncorrected visual acuity 0.04 ~ 0.4, the median 0.1, the best corrected visual acuity 0.1 ~ 0.8, the median 0.2,16 eye visual acuity below 0.3. Diopter + 18D ~ -18D, 15 eyes in ± 10D above. Postoperative visual acuity 0.2 ~ 0.6, the median 0.3; best corrected visual acuity of 0.4 to 1.0 at the end of follow-up, the median 0.7, all disabled. Diopters in one eye long-term development for the -7D, other equivalent spherical degrees were <3D; 2 eyes astigmatism> 2.5DC. Inflammatory reaction was mild after surgery, the two artificial lens implantation in the correction of visual acuity and postoperative inflammatory response and the incidence of surgical complications no significant difference. Conclusion The timely operation for the treatment of children with lens dislocation is beneficial to the visual development of children.