国际眼科纵览

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儿童白内障手术的治疗进展

张景尚 万修华   

  1. 100005首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2015-10-25 出版日期:2016-02-22 发布日期:2016-03-07
  • 通讯作者: 万修华,Email:xiuhuawan@126.com E-mail:xiuhuawan@126.com
  • 基金资助:

    北京市科技新星(H020821380190,Z131102000413025);国务院妇女儿童工作委员会课题(2014108);国家自然科学基金(30471861)

Surgical treatment for pediatric cataract

ZHANG Jing-shang, WAN Xiu-hua   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2015-10-25 Online:2016-02-22 Published:2016-03-07
  • Contact: WAN Xiu-hua, Email: xiuhuawan@126.com E-mail:xiuhuawan@126.com
  • Supported by:

    Beijing New Star of Science and Technology(H020821380190,Z131102000413025); Fund of Work Committee for Women and Children of China State Department(2014108); National Natural Science Fundation of China(30471861)

摘要:

儿童白内障是儿童可避免盲的原因之一,其治疗目前仍以手术为主。对于完全性白内障需尽早手术,可在3月龄后进行手术,术后应及时给予屈光矫正,1~2岁眼球进一步发育后再给予人工晶状体(introcular lens, IOL)植入;对于非完全性白内障可根据患儿视力情况择期进行手术并一期植入IOL。在进行儿童白内障手术时,联合后囊膜切除和前部玻璃体切除可有效防止术后后发性白内障的发生。儿童白内障术后随诊非常重要,可对术后并发症如青光眼等进行及时治疗和控制,并及时发现患儿的屈光不正,给予充分矫正,同时对患儿的弱视进行有效训练。近期通过医疗数据库和移动网络平台的方式,对患儿家长进行随访提醒、建立白内障患儿治疗康复的数据库等,有利于进一步优化和完善儿童白内障的手术治疗及术后随访,使治疗效果达到最佳。

Abstract:

Pediatric cataract is the main reason for children avoidable blindness. Surgery is still the main treatment method for the pediatric cataract. For the complete cataract, the surgery should be carried on as soon as possible after 3 months old, and refractive correction  should be timely given postoperatively. When the eyes further developed in 1~2 years old,  the intraocular lens (IOL)  can be implanted. For the incomplete cataract, the  surgery  can be carried on and  the IOL implanted at the same time according to the eyesight of children. In pediatric cataract surgery, resection of the posterior capsule and anterior vitreous can effectively prevent posterior capsule opacification. The follow up is very important after cataract surgery in children, because the postoperative complications such as glaucoma, can be timely treated and controlled,  the ametropia can be timely found and fully corrected, and the amblyopia can be effective training. Especially nowadays, through the medical databases and mobile network platform, parents of children with follow-up reminder can be stressed of strict follow-up. Establishing a database of pediatric cataract is conducive to further optimize and improve the surgical  managment and follow-up of pediatric cataract, so as to achieve the best therapeutic effect.