Abstract:【Objective】 To observe the efficacy and safety of different surgical approaches in infantile cataract surgery. 【Methods】 A total of 86 cases (137 eyes) of pediatric cataract patients treated in our hospital from July 2015 to September 2019 were included in the study. The patients were divided into an anterior approach group (47 cases) and a posterior approach group (39 cases) according to the surgical approaches. The children were followed up for 3 years after discharge. The axial length and corneal curvature of the two groups were measured and compared preoperatively, 6 months postoperatively, 1 year postoperatively, and 3 years postoperatively. The best corrected visual acuity of one eye and both eyes at the last follow-up visit, as well as the incidence of complications, were also compared between the two groups. 【Results】There were no significant differences in the axial length and corneal curvature between the two groups preoperatively, 6 months postoperatively, 1 year postoperatively, and 3 years postoperatively (P>0.05). The axial lengths at 6 months postoperatively, 1 year postoperatively, and 3 years postoperatively were significantly longer than those preoperatively, and the corneal curvatures were significantly smaller than those preoperatively in both groups (P<0.05). There were no significant differences in the best corrected visual acuity of one eye and both eyes at the last follow-up visit between the two groups (P>0.05). There were no significant differences in the incidences of iris adhesions, intraocular lens displacement, and secondary cataracts between the two groups (P>0.05). The anterior approach group had significantly lower incidences of strabismus and nystagmus than the posterior approach group (P<0.05). 【Conclusion】 Both posterior and anterior approaches in infantile cataract surgery can effectively treat cataracts. The anterior approach can reduce postoperative complications and has better clinical application value.
葛吉林, 张永康, 李波. 不同手术入路治疗婴儿期白内障的疗效及安全性分析[J]. 医学临床研究, 2024, 41(8): 1168-1170.
GE Jilin, ZHANG Yongkang, LI Bo. Efficacy and Safety of Different Surgical Approaches in Infantile Cataract Surgery. JOURNAL OF CLINICAL RESEARCH, 2024, 41(8): 1168-1170.
[1] LIMA S D , ERDAL N , ADOLFSSON K , et al.Rupture and chemical accumulation in contact lenses with dexamethasone eye drop administration after congenital cataract surgery[J].Acta Ophthalmol,2022,100(4):462-467. [2] RECHSTEINER D , ISSLER L S , KOLLER S , et al. Genetic analysis in a swiss cohort of bilateral congenital cataract[J].JAMA Ophthalmol,2021, 139(7):691-700. [3] LIMA S D , KUGELBERG M , JIRWE M . Congenital cataract in newborns: a qualitative study on parents' experiences of the surgery and subsequent care[J].Acta Ophthalmol,2020, 98(6):585-591. [4] ZHANG F , CHANG P J, ZHAO Y Y , et al. Incidence of posterior vitreous detachment after congenital cataract surgery: an ultrasound evaluation[J].Graefes Arch Clin Exp Ophthalmol, 2021, 259(2): 1045-1051. [5] 陈伟蓉.先天性白内障手术治疗的思考[J].中华眼科杂志, 2021, 57(1):11-16. [6] 李猛,王进达,张景尚,等.先天性白内障患者的眼生物测量数据分析[J].眼科,2021,30(1):36-41. [7] 俞铭蓉,顾骏祥,刘馨,等.不同手术入路先天性白内障术后并发症再手术的临床分析[J].中华眼视光学与视觉科学杂志,2018,20(1):40-45. [8] CHEN W S , HE S P, HU L X, et al. Ultrasound biomicroscopy for the assessment of postoperative complications after congenital cataract surgery[J].Quant Imaging Med Surg,2021,11(4):1483-1489. [9] 陈伟蓉.先天性白内障手术治疗的思考[J].中华眼科杂志,2021,57(1):11-16. [10] 徐晓玮,田爱军,郝微,等.不同手术入路的微创玻璃体切割系统对先天性白内障患儿术后并发症的影响[J].眼科新进展,2020,40(1):62-65. [11] 付燕,谢天皓,杨娜,等.内界膜剥除对孔源性视网膜脱离玻璃体切割术后黄斑前膜形成及视力预后的影响[J].中华实验眼科杂志,2022,40(1):62-66. [12] 陈伟蓉,王琦玮.应注意微创经睫状体平坦部玻璃体切割术在复杂白内障手术中的规范应用[J].中华实验眼科杂志,2020,38(4):281-284. [13] 李秋梅,刘畅,李鑫鑫,等.玻璃体切除术后飞秒激光辅助白内障超声乳化联合三焦点人工晶状体植入的初步效果观察[J].眼科,2020,29(4):288-293. [14] 张娅萍,马波,杜秀梅,等.后囊膜切开大小对先天性白内障术后远期预后的影响[J].中国眼耳鼻喉科杂志,2019,19(6):405-409. [15] 苗恒,侯宪如,鲍永珍.不同手术入路治疗婴儿期双眼先天性白内障的长期预后比较[J].中华眼科杂志,2019,55(1):46-50. [16] 张依,王文俊,杨安怀.经透明角膜入路的23G玻璃体切割术治疗先天性白内障疗效观察[J].山东医药,2020,60(33):53-55.