[1]谌文思,项道满.基于超声生物显微镜图像分型的先天性白内障摘出术后后发性白内障的手术设计及疗效观察[J].眼科新进展,2019,39(11):1063-1066.[doi:10.13389/j.cnki.rao.2019.0244]
 CHEN Wen-Si,XIANG Dao-Man.Surgical design and effect of posterior capsule opacification after extraction of congenital cataract based on ultrasound biomicroscopy image classification[J].Recent Advances in Ophthalmology,2019,39(11):1063-1066.[doi:10.13389/j.cnki.rao.2019.0244]
点击复制

基于超声生物显微镜图像分型的先天性白内障摘出术后后发性白内障的手术设计及疗效观察/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年11期
页码:
1063-1066
栏目:
应用研究
出版日期:
2019-11-05

文章信息/Info

Title:
Surgical design and effect of posterior capsule opacification after extraction of congenital cataract based on ultrasound biomicroscopy image classification
作者:
谌文思项道满
510623 广东省广州市,广州医科大学附属广州市妇女儿童医疗中心眼科
Author(s):
CHEN Wen-SiXIANG Dao-Man
Department of Pediatric Ophthalmology,Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou 510623,Guangdong Province,China
关键词:
超声生物显微镜先天性白内障后发性白内障Nd:YAG激光玻璃体切割术
Keywords:
ultrasound biomicroscopycongenital cataractposterior capsule opacificationNd:YAG laservitrectomy
分类号:
R779.7
DOI:
10.13389/j.cnki.rao.2019.0244
文献标志码:
A
摘要:
目的 基于超声生物显微镜(ultrasound biomicroscope,UBM)对先天性白内障摘出术后后发性白内障(posterior capsular opacification,PCO)图像特征的影像学分类,探讨PCO类型与手术方式选择的关系。方法 对在广州市妇女儿童医疗中心行先天性白内障摘出术,术后采用水囊式UBM成像技术进行检查,并确诊为PCO的27例(40眼)患儿的UBM检查结果进行分析。根据UBM图像特征将PCO分为3组,并根据分型实施不同的手术方式:膜性纤维化型组采用Nd:YAG激光晶状体后囊膜切开术,皮质再生型组采用前段玻璃体切割术,混合型组采用前段玻璃体切割联合电子撕囊术。术后定期随访并复查UBM。结果 全部术眼术中视轴区混浊均被清除,晶状体后囊膜中央切口均为直径3.0~4.0 mm的圆形透明区,PCO手术的成功率为100%。术后随访6~30个月,膜性纤维化型组20眼中2眼发生虹膜粘连、瞳孔膜样闭锁,再次手术,采用虹膜后粘连分离联合前段玻璃体切割术治疗,术后未再次复发;皮质再生型组14眼和混合型组6眼术后视轴区均未再次出现混浊。PCO术后总复发率为5.0%。结论 对先天性白内障摘出术后PCO的UBM图像进行分型,有助于最佳手术方式的选择,可达到更好的治疗效果。
Abstract:
Objective To explore the relationship between the types of posterior capsule opacification (PCO) and the surgical methods based on ultrasound biomicroscope (UBM) image classification of PCO.Methods The imaging results of UBM in 27 patients (40 eyes),who were diagnosed with PCO examined by high-resolution bag/balloon UBM technique after undergoing congenital cataract extraction in Guangzhou Women and Children’s Medical Center,were analyzed.These patients were divided into three groups according to UBM image characteristics,and different operation methods were carried out according to the classification:Nd:YAG laser posterior capsulotomy was used in the membrane fibrosis group,anterior vitrectomy was used in the cortex regeneration group,and anterior vitrectomy was used in the mixed group.UBM was regularly performed during followed up.Results The opacity of the visual axis was cleared during operation.The central incision of posterior capsule of lens was a round transparent area with a diameter of 3.0-4.0 mm.The success rate of PCO is 100%.After 6-30 months of follow-up,2 eyes in the membrane fibrosis group had iris adhesion and mydriatic atresia,and then they underwent iris adhesion separation combined with anterior vitrectomy,without recurrence.No any haze occurred in 14 eyes of the cortex regeneration group and 6 eyes of the mixed type group.The total recurrence rate of PCO was 5.0%.Conclusion The classification of PCO images after congenital cataract extraction is helpful to choose the best surgical method and can achieve better therapeutic effect.

参考文献/References:

[1] MEDSINGE A,NISCHAL K K.Pediatric cataract:challenges and future directions[J].Clin Ophthalmol,2015,9:77-90.
[2] GASPER C,TRIVEDI R H,WILSON M E.Complications of pediatric cataract surgery[J].Dev Ophthalmol,2016,57:69-84.
[3] ASTLE W F,ALEWENAH OINGRAM A D.Surgical outcomes of primary foldable intraocular lens implantation in children:understanding posterior opacification and the absence of glaucoma[J].J Cataract Refract Surg,2009,35(7):1216-1222.
[4] SHRESTHA U D,SHRESTHA M K.Visual axis opacification in children following pediatric cataract surgery[J].JNMA J Nepal Med Assoc,2014,52(196):1024-1030.
[5] SUBASH M,HORGAN S E.Nd:YAG laser capsulotomy in the prone position under general anesthesia[J].Ophthalmic Surg Lasers Imaging,2008,39(3):257-259.
[6] VASAVADA A R,PRAVEEN M R,TASSIGNON M J,SHAH S K,VASAVADA V A,VAN L J,et al.Posterior capsule management in congenital cataract surgery[J].J Cataract Refract Surg,2011,37(1):173-193.
[7] HEJTMANCIK J F.Congenital cataracts and their molecular genetics[J].Sem Cell Dev Biol,2008,19(2):134.
[8] ZHANG J S,WANG J D,XIONG Y,LI J,WAN X H.Effects of different treatments on posterior capsule opacification after lens implantation in children[J].Rec Adv Ophthalmol,2016,36(10):928-931.
张景尚,王进达,熊瑛,李婧,万修华.不同方式治疗儿童后发性白内障的疗效观察[J].眼科新进展,2016,36(10):928-931.
[9] BRAD K M,ATKINSON C S,KILTY L A,HILES D A.Cataract surgery and intraocular lens implantation in children[J].Am J Ophthalmol,1995,120(1):1.
[10] CUI M W,LIN H R,MA R Q,MENG F L,XU Y M.Anterior vitrectomy in complicated anterior segmental operation[J].Med J Chin Peoples Armed Police Forces,2009,20(3):217-220.
崔明伟,林会儒,马荣庆,孟凡玲,许艺民.前部玻璃体切割术在眼前节手术中的应用[J].武警医学,2009,20(3):217-220.
[11] SHEARD R M,GOODBURN S F,COMER M B,SCOTT J D,SNEAD M P.Posterior vitreous detachment after Nd:YAG laser posterior capsulotomy[J].J Cataract Refract Surg,2003,29(5):930-934.
[12] XIANG D M,CHEN L H,HU L X,SONG S F,XIE W H,LONG J J.Image features of lens opacity in pediatric cataracts using ultrasound biomicroscopy[J].J AAPOS,2016,20(4):519-522.
[13] LONG J J,XIANG D M,GUO Z,CHEN L H,CHEN F,WANG J X,et al.Clinical characteristics and surgical procedures for children with congenital membranous cataract[J].J Ophthalmol,2017,2017:2370969.

相似文献/References:

[1]马瑞 刘伟 季建.原发性闭角型青光眼行白内障超声乳化联合人工晶状体植入术后超声生物显微镜观察[J].眼科新进展,2012,32(11):000.
[2]唐东永 李霞 梁皓 何剑 谭少健.应用超声生物显微镜观察Bigbag人工晶状体在高度近视眼囊袋内的稳定性[J].眼科新进展,2013,33(6):000.
[3]赵博 马世江 陈革 王永毅.傅立叶域光学相干断层扫描、A型超声测厚仪和超声生物显微镜测量角膜厚度的相关性分析[J].眼科新进展,2013,33(7):000.
[4]刘晓航 陶海.泪道超声检查研究进展[J].眼科新进展,2012,32(7):000.
[5]杨海燕 张红.超声生物显微镜在经巩膜睫状体光凝治疗晚期难治性青光眼中的应用[J].眼科新进展,2012,32(9):000.
[6]周伟雄 刘照耀 桂曼芸.超声生物显微镜对慢性闭角型青光眼合并白内障手术疗效的评价研究[J].眼科新进展,2012,32(9):000.
[7]杜改萍 郭慧玲 董莹 王丽强 葛梅 黄一飞.超声生物显微镜在有晶状体眼后房型人工晶状体植入术中的应用[J].眼科新进展,2012,32(10):000.
[8]邵珺 朱靖 储兆东 禹倩倩 陶永辉 黄玉政 姚勇.先天性白内障患者和正常人晶状体蛋白质组的差异分析[J].眼科新进展,2013,33(4):000.
[9]宋金鑫 孙乃学.原发性闭角型青光眼的超声生物测量研究[J].眼科新进展,2013,33(4):000.
[10]白芳 陶海. 泪点栓或泪小管栓置入后继发泪小管炎的临床诊治[J].眼科新进展,2014,34(3):264.

备注/Memo

备注/Memo:
广东省科技厅基金资助(编号:2016A020212002);广东省科技公益研究与能力建设项目(编号:2014B020212019)
更新日期/Last Update: 2019-11-18