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目的:探讨婴幼儿先天性白内障手术后并发症的相关因素。方法:对年龄在1.5～30月龄的婴幼儿105例(186眼)先天性白内障进行回顾性研究。按患儿接受手术时年龄分为4组:<3月龄为1组,4～6月龄为2组,7～12月龄为3组,13～30月龄为4组。患眼全部采用白内障皮质吸除+后囊膜连续环形撕囊(posterior coutinuous circular capsulourhexis,PCCC)+前段玻璃体切除术(anterior vitrectomy,AV)。术后随访6～30mo,观察术后近期(1mo内)及远期(最长30mo)的并发症发生情况。分析先天性白内障术后并发症的发生与手术方式及手术时患儿年龄等因素之间的关系。结果:术后1mo内,1组术后无晶状体青光眼发病率为25%,角膜水肿发生率为57%,前房纤维素性虹膜炎发生率为12%;2组分别为5%,31%及11%;3组分别为3%,24%及4%;4组分别为0,17%及4%;在术后3～30mo随访中发现,1组有51%术眼发生不同程度的虹膜粘连,占各组之首。结论:先天性白内障术后并发症的发生与手术时患儿的年龄及手术方式有关:对于联合后囊膜及前段玻璃体切除的婴幼儿白内障手术,年龄越小,术后无晶状体青光眼、角膜水肿及虹膜炎等并发症发生的机会越大。
Objective: To investigate the related factors of postoperative complication in infants with congenital cataract. Methods: A retrospective study was performed on 105 cases (186 eyes) of congenital cataracts in infants and young children aged 1.5 months to 30 months. According to the age of the children undergoing surgery, they were divided into 4 groups: <3 months old was 1 group, 4 ~ 6 months old was 2 groups, 7 ~ 12 months old was 3 groups, 13 ~ 30 months old was 4 groups. All eyes were cataract treated with cataract and posterior coutinuous circular capsulorhexis (PCCC) + anterior vitrectomy (AV). Postoperative follow-up 6 ~ 30mo, observed postoperative (within 1mo) and long-term (up to 30mo) complication. To analyze the relationship between the incidence of complications after congenital cataract surgery and surgical methods and children age and other factors. Results: Within 1 month after operation, the incidence of aphakic glaucoma in group 1 was 25%, the incidence of corneal edema was 57%, and the incidence of anterior chamber cellulose iris was 12%. The incidence of aphakic glaucoma in group 1 was 5%, 31% and 11%; 3 groups were 3%, 24% and 4%; 4 groups were 0,17% and 4%; 3 ~ 30mo postoperative follow-up found that a group of 51% Adhesion, the first of each group. CONCLUSIONS: The incidence of postoperative complications of congenital cataract is related to the age and surgical approach of the children undergoing surgery. For cataract surgery combined with posterior vitrectomy and anterior vitrectomy, the younger the age, the more the incidence of aphakia, corneal edema And the greater the chance of complications such as iritis.