比较聚甲基丙烯酸甲酯与疏水性丙烯酸酯人工晶状体在小儿白内障手术中的应用

Comparison of polymethylmethacrylate versus hydrophobic acrylic lenses for primary intraocular lens implantation in pediatric cataract surgery

摘要:

目的：比较聚甲基丙烯酸甲酯(PMMA)与疏水性丙烯酸酯人工晶状体(IOLs)用于小儿白内障摘除联合人工晶状体植入术术后视力效果及并发症。

方法：回顾性研究。包括63例117眼接受双侧小儿白内障手术和原发性人工晶状体植入术患者。将所有患者分为两组，组I包括30例58眼植入聚甲基丙烯酸甲酯人工晶状体患者； 组II包括33例59眼植入疏水性丙烯酸酯人工晶状体患者。比较两组间的临床特点、屈光不正、最佳矫正视力(BCVA)和手术并发症。

结果：患者平均年龄为5.8(2～12)岁，平均随访时间为40.5(6～196)mo。术后，80眼(68.4%)中最佳矫正视力 ≥0.5，两组间存在可比性。两组间视觉轴混浊情况分别为组I 28眼(48.3%)，组II 16眼(27.1%)，两组间差异有统计学意义(P=0.018)。术后形成眼内晶状体脱位和粘连。综上所述，疏水性丙烯酸酯人工晶状体组的并发症明显少于聚甲基丙烯酸甲酯人工晶状体组(P=0.020)。

结论：采用原发性人工晶状体植入术行小儿白内障手术是一种安全的方法。相较于聚甲基丙烯酸甲酯人工晶状体，疏水性丙烯酸人工晶状体术后并发症更少。

Abstract:

AIM: To compare the visual results and postoperative complications of polymethylmethacrylate(PMMA)and hydrophobic acrylic intraocular lenses(IOLs)in children who underwent cataract extraction with primary IOL implantation.

METHODS:This retrospective study included 117 eyes of 63 children with bilateral pediatric cataract undergoing cataract surgery and primary IOL implantation. The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs; Group II included 59 eyes of 33 patients with hydrophobic acrylic IOLs. The clinical features, refraction errors, best corrected visual acuity(BCVA)and surgical complications were compared between two groups.

RESULTS:The mean age at the time of surgery was 5.8(2-12)y and mean follow up period was 40.5(6-196)mo. Postoperatively, BCVA was ≥0.5 in 80 eyes(68.4%)and this was comparable in two groups. Visual axis opacification was seen in 28 eyes(48.3%)in Group I and 16 eyes(27.1%)in Group II and this difference was statistically significant(P=0.018). Postoperative IOL dislocation and posterior synechia formation were also noted. When all postoperative complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group(P=0.020).

CONCLUSION: Pediatric cataract surgery with primary IOL implantation is a safe procedure. Hydrophobic acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.