Vijayalakshmi Perumalsamy, Srivastava Kuldeep Kumar, Poornima Balajee, Nirmalan Praveen
Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Care System, Madurai, India.
J AAPOS. 2003 Apr;7(2):91-5. doi: 10.1016/mpa.2003.S1091853102420022.
To evaluate visual outcome after cataract surgery in children with congenital rubella syndrome (CRS).
A retrospective analysis was conducted on 40 eyes of 22 children with CRS who underwent cataract surgery. Thirty-six eyes underwent lensectomy with anterior vitrectomy, and 4 eyes underwent extracapsular cataract extraction with primary posterior capsulectomy. The median age at surgery was 6 months, and median duration of postoperative follow up was 68.5 months. Each follow-up visit consisted of visual acuity estimation, refraction, anterior and posterior segment examination, and intraocular pressure measurements.
Visual acuity at final follow up was 6/24 or better in 6 (15.0%) eyes, and 22 (55.0%) eyes had visual acuity less than 3/60. Postoperative complications included transient corneal edema in 18 (45.0%) eyes, glaucoma in 5 (12.5%) eyes, after cataract in 1 (2.5%) eye, and hyphema in 1 (2.5%) eye. Ocular disorders affecting visual outcome included stimulus deprivation amblyopia, glaucoma, optic atrophy, corneal opacity, and after cataract. Associated systemic disorders included neurological problems in 15 (68.2%), hearing loss in 12 (54.6%), cardiovascular problems in 9 (40.9%), and speech abnormalities in 7 (31.8%) children.
The less-than-optimal postoperative visual outcome suggests the need to look at primary prevention of rubella, especially in developing countries.
评估先天性风疹综合征（CRS）患儿白内障手术后的视力预后。
对22例接受白内障手术的CRS患儿的40只眼进行回顾性分析。36只眼行晶状体切除术联合前部玻璃体切除术，4只眼行囊外白内障摘除术联合一期后囊膜切开术。手术时的中位年龄为6个月，术后中位随访时间为68.5个月。每次随访包括视力评估、验光、眼前段和眼后段检查以及眼压测量。
末次随访时，6只眼（15.0%）的视力为6/24或更好，22只眼（55.0%）的视力低于3/60。术后并发症包括18只眼（45.0%）出现短暂性角膜水肿，5只眼（12.5%）发生青光眼，1只眼（2.5%）出现后发性白内障，1只眼（2.5%）发生前房积血。影响视力预后的眼部疾病包括形觉剥夺性弱视、青光眼、视神经萎缩、角膜混浊和后发性白内障。相关的全身性疾病包括15例（68.2%）患儿有神经问题，12例（54.6%）有听力损失，9例（40.9%）有心血管问题，7例（31.8%）有言语异常。
术后视力预后欠佳提示有必要关注风疹的一级预防，尤其是在发展中国家。
