Cataract Surgery in Children from Birth to Less than 13 Years of Age: Baseline Characteristics of the Cohort

详细信息    查看全文

• 作者：Michael X. Repka ; MD ; MBA¹ ; ^{pedig@jaeb.org" class="auth_mail" title="E-mail the corresponding author} ; Trevano W. Dean ; MPH² ; Elizabeth L. Lazar ; MSPH² ; Kimberly G. Yen ; MD³ ; Phoebe D. Lenhart ; MD⁴ ; Sharon F. Freedman ; MD⁵ ; Denise Hug ; MD⁶ ; Bahram Rahmani ; MD⁷ ; Serena X. Wang ; MD⁸ ; Raymond T. Kraker ; MSPH² ; David K. Wallace ; MD ; MPH⁵ ; for the Pediatric Eye Disease Investigator Group^&lowast ;
• 关键词：BCCIG ; British Isles Congenital Cataract Interest Group ; CI ; confidence interval ; D ; diopter ; IATS ; Infant Aphakia Treatment Study ; IOL ; intraocular lens ; OR ; odds ratio ; PEDIG ; Pediatric Eye Disease Investigator Group ; SD ; standard deviation
• 刊名：Ophthalmology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：123
• 期：12
• 页码：2462-2473
• 全文大小：1645 K

文摘

To describe baseline characteristics, initial postoperative refractive errors, operative complications, and magnitude of the intraocular lens (IOL) prediction error for refractive outcome in children undergoing lensectomy largely in North America.

Design

Prospective registry study of children from birth to <13 years of age who underwent lensectomy for any reason within 45 days preceding enrollment.

Participants

Total of 1266 eyes of 994 children; 49% female and 59% white.

Methods

Measurement of refractive error, axial length, and complete ophthalmic examination.

Main Outcome Measures

Eye and systemic associated conditions, IOL style, refractive error, pseudophakic refraction prediction error, operative and perioperative complications.

Results

Mean age at first eligible lens surgery was 4.2 years; 337 (34%) were <1 year of age. Unilateral surgery was performed in 584 children (59%). Additional ocular abnormalities were noted in 301 eyes (24%). An IOL was placed in 35 of 460 eyes (8%) when surgery was performed before 1 year of age, in 70 of 90 eyes (78%) from 1 to <2 years of age, and in 645 of 716 eyes (90%) from 2 to <13 years of age. The odds of IOL implantation were greater in children ≥2 years of age than in those <2 years of age (odds ratio = 29.1; P < 0.001; 95% confidence interval: 19.6–43.3). Intraoperative complications were reported for 69 eyes (5%), with the most common being unplanned posterior capsule rupture in 14 eyes, 10 of which had an IOL placed. Prediction error of the implanted IOL was <1.00 diopter in 54% of eyes, but >2.00 diopters in 15% of eyes.

Conclusions

Lensectomy surgery was performed throughout childhood, with about two-thirds of cases performed after 1 year of age. Initial surgery seemed safe, with a low complication rate. IOL placement was nearly universal in children 2 years of age and older. The immediate postoperative refraction was within 1 diopter of the target for about one-half of eyes.