【摘要】 目的总结先天性虹膜-脉络膜缺损患者的病变特征、伴随症状、诊疗及其预后,以便更好地指导临床实践。方法收集我院2008年至2010年住院患者中发现的先天性虹膜-脉络膜缺损患者,将其眼科检查、病变特征、治疗及预后加以总结。结果 14例24眼患者均表现为典型的下方虹膜缺损,脉络膜为视盘下方4点到6点钟位的片状扇形缺损,缺损大小相似。主要并发症为:小眼球、小角膜、斜视、眼球震颤、弱视、屈光不正、视力低下、白内障、青光眼及视网膜脱离等。年龄相关性白内障(7/14)、视网膜脱离(5/14)及开角型青光眼(2/14)为患者入院的主要原因,白内障超声乳化联合人工晶状体植入术后1a视力为0.5～1.0,视力提高在6行以上;玻璃体切割联合眼内光凝及硅油填充术后1a视力为0.05～0.3,复位率为100%;复合式小梁切除术后1a视力稍有下降,仍在数指/30cm～0.4之间。结论临床上对先天性虹膜-脉络膜缺损的患者应行全面眼科检查,及早发现影响这类患者视力的并发症,并给予积极治疗。更多还原

【Abstract】 Objective To summarize the clinical characteristics,symptoms,diagnosis,treatment and prognosis of congenital coloboma of iris and choroid for better guidance of clinical practice.Methods The clinical data were collected from the patients diagnosed as congenital coloboma of iris and choroid in our hospital from 2008 to 2010.The ophthalmic examinations,pathological characteristics,treatment and prognosis of these patients were summarized.Results Twenty-four eye in 14 cases all exhibited typical inferior coloboma of iris.The choroidal coloboma was a large fan-shaped defect spanning 4 to 6 o’clock below optic disc.The coloboma was with similar size.The main complications of these patients included microphthalmia,small corneal,strabismus,nystagmus,amblyopia,refractive error,low vision,age-related cataract,glaucoma and retinal detachment.Age-related cataract(7 cases),retinal detachment(5 cases) and open-angle glaucoma(2 cases) were the main reasons to be admitted to the hospital.One year after phacoemulsification and intraocular lens implantation,the visual acuity in operated eyes of these patients was from 0.5 to 1.0,which improved more than six lines.After vitrectomy combined with intraocular photocoagulation and silicone oil tamponade,one year following the surgery the visual acuity in operated eyes was from 0.05 to 0.3,and the retinal re-attached rate was 100%.After composite trabeculectomy,the visual acuity decreased slightly one year,but was still between counting fingers/30 cm and 0.4.Conclusion Comprehensive eye examination should be performed for the patients with congenital coloboma of iris and choroid in clinical practice,so that the main vision-threatening complications can be detected and treated as early as possible.更多还原