促进婴幼儿白内障术后正常屈光发育的手术治疗策略
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摘要
目的:回顾性观察Ⅰ期植入IOL治疗婴幼儿白内障术后远期眼球屈光发育和并发症情况。方法:回顾性系列病例研究。对10a内曾行白内障摘除+前后撕(切)囊联合前段玻璃体切割+Ⅰ期IOL(同一种IOL计算公式)植入术的先天性白内障患儿46例92眼的术后并发症、眼轴、矫正视力、屈光状态等进行回顾性分析。结果:患者出现术后并发症者5眼(5%)。患儿术后3a随访矫正视力平均0.40±0.10,术后5a随访矫正视力平均0.51±0.01,术后7a随访矫正视力平均0.71±0.01;术后3a眼轴长度20.04±0.02mm,术后5a眼轴长度22.09±0.09mm,术后7a眼轴长度22.96±0.06mm;术后3a的平均屈光状态(等效球镜度数)为+5.37±0.12DS,术后5a的平均屈光状态+3.20±0.20DS,术后7a的平均屈光状态+0.92±0.20DS。结论:制定合适的手术治疗策略可以安全有效地给予婴幼儿白内障患儿相对正常屈光发育的机会。
?AIM: To observe the eye development and complications after primary intraocular lens implantation(IOL) in infantile cataract.?METHODS: The postoperative complications, corrected vision, refractive state, ocular axis of 46 patients(92 eyes) with congenital cataract treated by IOL implantation within 10 y were retrospectively analyzed.?RESULTS: Five eyes(5%) had postoperative complications. In this study, the average corrected visual acuity was 0.40±0.10 at 3 a follow-up after surgery, 0.51±0.01 at 5 a follow-up after surgery, and 0.71±0.01 at 7 a follow-up; The axial length of the eyes was 20.04±0.02 mm at 3 a after surgery, 22.09±0.09 mm at 5 a after surgery, and the axial length of the eyes was 22.96±0.06 mm at 7 a after surgery; The mean refractive state(equivalent spherical lens degree) at 3 a after surgery was observed to be +5.37±0.12 DS, +3.20±0.20 DS at 5 a after surgery, and +0.92±0.20 DS at 7 a after surgery.?CONCLUSION: The appropriate surgical strategies can give safely and effectively opportunity for the patients with infantile cataract, which also have relatively normal refractive development.
?AIM: To observe the eye development and complications after primary intraocular lens implantation(IOL) in infantile cataract.?METHODS: The postoperative complications, corrected vision, refractive state, ocular axis of 46 patients(92 eyes) with congenital cataract treated by IOL implantation within 10 y were retrospectively analyzed.?RESULTS: Five eyes(5%) had postoperative complications. In this study, the average corrected visual acuity was 0.40±0.10 at 3 a follow-up after surgery, 0.51±0.01 at 5 a follow-up after surgery, and 0.71±0.01 at 7 a follow-up; The axial length of the eyes was 20.04±0.02 mm at 3 a after surgery, 22.09±0.09 mm at 5 a after surgery, and the axial length of the eyes was 22.96±0.06 mm at 7 a after surgery; The mean refractive state(equivalent spherical lens degree) at 3 a after surgery was observed to be +5.37±0.12 DS, +3.20±0.20 DS at 5 a after surgery, and +0.92±0.20 DS at 7 a after surgery.?CONCLUSION: The appropriate surgical strategies can give safely and effectively opportunity for the patients with infantile cataract, which also have relatively normal refractive development.
引文
1 Francis PJ,Ionides A,Berry V,et al.Visual outcome in patients with isolated autosomal dominant congenital cataract.Ophthalmology 2001;108(6):1104-1108
2 Chak M,Rahi JS,British Congenital Cataract Interest Group.Incidence of and factors associated with glaucoma after surgery for congenital cataract:findings from the British Congenital Cataract Study.Ophthalmology 2008;115(6):1013-1018
3赵家良.全面深入地展开我国防盲治盲工作:《解读全国防盲治盲规划(2012-2015年)》.中华眼科杂志 2013;49(9):769-773
4陈伟蓉,陈卉,林浩添.先天性白内障治疗现状及展望.中华眼视光学与视觉科学杂志 2018;20(1):1-6
5 Hubel DH,Wiesel TN.Laminar and columnar distribution of geniculo-cortical fibers in the macaque monkey.J Comp Neurol 2010;146(4):421-450
6 Lin H,Chen W,Luo L,et al.Ocular hypertension after pediatric cataract surgery:baseline characteristics and first-year report.PLoS One 2013;8(7):e69867
7 Negalur M,Sachdeva V,Neriyanuri S,et al.Long-term outcomes following primary intraocular lens implantation in infants younger than 6 months.Indian J Ophthalmol 2018;66(8):1088-1093
8 Vasavada AR,Vasavada V,Shah SK,et al.Five-Year Postoperative Outcomes of Bilateral Aphakia and Pseudophakia in Children up to 2 Years of Age:A Randomized Clinical Trial.Am J Ophthalmol 2018;193:33-44
9杨爽,宋旭东.先天性白内障人工晶状体植入术后眼球发育和屈光的变化.国际眼科纵览 2012;36(5):327-330
10 Nowak M,Chaniecki P.Assessment of visual acuity in aphakia patient after bilateral cataract removal.Pol Merkur Lekarski 2018;44(264):287-288
2 Chak M,Rahi JS,British Congenital Cataract Interest Group.Incidence of and factors associated with glaucoma after surgery for congenital cataract:findings from the British Congenital Cataract Study.Ophthalmology 2008;115(6):1013-1018
3赵家良.全面深入地展开我国防盲治盲工作:《解读全国防盲治盲规划(2012-2015年)》.中华眼科杂志 2013;49(9):769-773
4陈伟蓉,陈卉,林浩添.先天性白内障治疗现状及展望.中华眼视光学与视觉科学杂志 2018;20(1):1-6
5 Hubel DH,Wiesel TN.Laminar and columnar distribution of geniculo-cortical fibers in the macaque monkey.J Comp Neurol 2010;146(4):421-450
6 Lin H,Chen W,Luo L,et al.Ocular hypertension after pediatric cataract surgery:baseline characteristics and first-year report.PLoS One 2013;8(7):e69867
7 Negalur M,Sachdeva V,Neriyanuri S,et al.Long-term outcomes following primary intraocular lens implantation in infants younger than 6 months.Indian J Ophthalmol 2018;66(8):1088-1093
8 Vasavada AR,Vasavada V,Shah SK,et al.Five-Year Postoperative Outcomes of Bilateral Aphakia and Pseudophakia in Children up to 2 Years of Age:A Randomized Clinical Trial.Am J Ophthalmol 2018;193:33-44
9杨爽,宋旭东.先天性白内障人工晶状体植入术后眼球发育和屈光的变化.国际眼科纵览 2012;36(5):327-330
10 Nowak M,Chaniecki P.Assessment of visual acuity in aphakia patient after bilateral cataract removal.Pol Merkur Lekarski 2018;44(264):287-288