方法：回顾性系列病例研究。选择2013-05/2017-08于我院眼科确诊为先天性白内障，年龄为3月龄～5岁4个月的患儿38例55眼纳入本研究。根据患者治疗方案分为A组和B组，A组17例25眼接受25G微创晶状体切除联合前段玻璃体切除术，B组21例30眼接受白内障超声乳化吸除联合前段玻璃体切除术。术后随访36～74(平均43.4)mo，对比观察两组患儿术后BCVA、眼轴、术中术后并发症。

结果：两组年龄、性别、病程、术前BCVA、术前眼轴等基线水平均无差异(P>0.05)。两组患者术后BCVA均较术前明显提高(P<0.05)。术后6mo A组BCVA明显优于B组(P=0.043)，而术后12、24、36mo两组BCVA无差异(P=0.727、0.286、0.889)。A组、B组术后6mo眼轴与术前均无明显差异(P=0.206、0.082)，术后12、24、36mo眼轴均较术前变长(A组：P=0.023、0.015、<0.01； B组：P=0.018、<0.01、<0.01)。两组术后6、12、24、36mo眼轴均无差异(P=0.195、0.313、0.485、0.089)。A组并发症的发生率明显低于B组(P=0.042)。

结论：25G微创晶状体切割联合后囊膜切开及前段玻璃体切除术能有效改善先天性白内障患者的视力，且术后并发症较少，是治疗先天性白内障的一种安全、有效的方法。

METHODS: This retrospective case series study included 55 eyes of 38 children with congenital cataract, age from 3mo to 5 years old, who were recruited between May 2013 and August 2017. The children were divided into two groups according to the different surgical methods. Group A(25 eyes of 17 children)received a 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy, and group B(30 eyes of 21 children)received a cataract phacoemulsification combined with capsulotomy and anterior vitrectomy. The mean follow-up time was 43.4(range: 36-74)mo. The postoperative best corrected visual acuity(BCVA), axial length, and complications were compared.

RESULTS: The age, sex distribution, duration, preoperative BCVA, and preoperative axial lengths were not significantly different between the two groups(P>0.05). The BCVA improved significantly at postoperative compared with BCVA at baseline in both gorups(Group A: P<0.001; Group B: P<0.001). The BCVA was better in Group A than Group B at 6mo postoperatively(P=0.043). No statistically significant difference was found in BCVA between the two groups at 12, 24 and 36mo after initial treatment(P=0.727, P=0.286, P=0.889). No statistically significant difference was found in axial lengths between 6mo of postoperation and preoperation in both groups(Group A: P=0.206, Group B: P=0.082). The mean postoperative axial lengths at 12, 24 and 36mo were longer than that at baseline in both group(Group A: P=0.023, P=0.015, P<0.01, Group B: P=0.018, P<0.01, P<0.01). There were no significantly different in mean axial length after operation between the two groups(6mo: P=0.195, 12mo: P=0.313, 24mo: P=0.485, 36mo: P=0.089). The rate of postoperative complications was lower in Group A than Group B(P=0.042).

CONCLUSION: 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy is an effective and safe treatment method for congenital cataract, the visual acuity after treatment was improved significantly.