先天性白内障是世界上儿童失明的主要原因，由于其在儿童出生时即造成视力障碍，妨碍了视觉系统的正常发育，对儿童的生活质量造成严重影响。因此及时诊断并采取有效和安全的干预措施，特别是在视觉发育的关键期内，变得尤为迫切与重要。手术摘除白内障是治疗的重要手段，其成功与否以及术后患儿的视觉恢复效果和并发症发生情况，很大程度上取决于手术方式的选择，包括手术入路（前入路：角膜/角巩膜缘切口；后入路：睫状体平坦部）、手术器械（玻璃体切割头切口：20G、23G、25G）。不同的手术入路，直接关系到术后并发症的发生率且显著影响术后视力恢复。本文综述和分析相关问题，旨在为临床提供参考。

Congenital cataract is a leading cause of childhood blindness worldwide. By inducing visual impairment from birth, it disrupts the normal development of the visual system and profoundly impacts patients’ quality of life. Therefore, timely diagnosis and the implementation of effective, safe interventions, particularly during the critical period of visual development, are of paramount clinical importance. Cataract extraction is a cornerstone therapeutic intervention. The success of the surgery, as well as postoperative visual recovery and the incidence of complications in pediatric patients, largely depends on the selected surgical approach and instrumentation. Surgical approaches are primarily categorized into the anterior approach (via corneal or limbal incision) and the posterior approach (via pars plana). Surgical instruments are typically classified by the gauge of the vitreous cutter, such as 20-gauge (20G), 23-gauge (23G), and 25-gauge (25G). The choice of surgical approach not only directly influences the incidence of postoperative complications but also significantly impacts visual recovery. This article reviews and analyzes these critical aspects to provide valuable guidance for clinical practice.