Autrata R, Rehůrek J
Dĕtská ocní klinika FN a LF MU, Brno.
Cesk Slov Oftalmol. 2000 Sep;56(5):303-10.
To evaluate the results of primary and secondary implantations of intraocular lenses (IOL) in children--visual acuity, binocular function, resulting refraction and complications after operation.
The group comprises 47 eyes of 36 children operated in 1993-1997, aged 5-16 years (mean age of operated children 10.3 years). The follow up period after operation was 18-60 months. The mean follow period was 37 months. Twenty-two primary implantations of posterior chamber IOL were made and 25 secondary implantations, incl. 13 posterior chamber IOL and 12 anterior chamber IOL. From the total number of cataracts 26 were traumatic and 21 congenital (16 bilateral and 5 unilateral).
A visual acuity of 6/12 or better was recorded after operation in 31 (67%) eyes, incl. vision 6/6 in 7 eyes. Vision 6/15 to 6/24 was found in 8 (18%) eyes. Binocular function after operation was recorded in 26 (73%) children. Of these 11 have stereopsis and 15 have fusion I-III. Nine children (27%) do not have binocular functions. Half the eyes have after operation a refraction within the interval +/- 1.0 D SE. Fifteen eyes (33%) are within the range of +/- 2 D SE from emetropy. Eight eyes had a refraction in the interval of +/- 3 D SE during the last check-up examination. The most frequent postoperative complication was a slight (48%) or more serious (23%) inflammatory reaction, decentration of the IOL (23%), and in case posterior capsulotomy was not performed during primary implantation, the complication in almost 8% of eyes was secondary cataract which had to be treated by capsulotomy with a NdYAG laser. One intraocular lens had to be explanted.
Implantation of an intraocular lens in children aged 5-16 years is according to the results of postoperative visual acuity and binocular functions a suitable alternative of correction of child aphakia.
评估儿童人工晶状体（IOL）一期和二期植入的效果——视力、双眼视功能、术后屈光状态及并发症。
该组包括1993年至1997年接受手术的36名儿童的47只眼，年龄5至16岁（手术儿童平均年龄10.3岁）。术后随访期为18至60个月。平均随访期为37个月。行22例后房型IOL一期植入，25例二期植入，包括13例后房型IOL和12例前房型IOL。在所有白内障病例中，26例为外伤性，21例为先天性（16例双侧，5例单侧）。
术后31只眼（67%）视力达到6/12或更好，其中7只眼视力为6/6。8只眼（18%）视力为6/15至6/24。26名（73%）儿童术后记录到双眼视功能。其中11名有立体视，15名有I - III级融合。9名儿童（27%）没有双眼视功能。半数眼睛术后屈光在±1.0 D SE范围内。15只眼（33%）距正视眼在±2 D SE范围内。在最后一次检查时，8只眼的屈光在±3 D SE范围内。最常见的术后并发症是轻度（48%）或更严重（23%）的炎症反应、IOL偏心（23%），如果一期植入时未行后囊切开术，近8%的眼会发生继发性白内障，需用Nd:YAG激光行囊切开术治疗。1枚人工晶状体不得不取出。
根据术后视力和双眼视功能结果，5至16岁儿童植入人工晶状体是矫正儿童无晶状体眼的合适选择。
