Yang Meng-Ling, Hou Chiun-Ho, Lee Jiahn-Shing, Liang Yu-Sung, Kao Ling-Yuh, Lin Ken-Kuo
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fu-Shing Street, Kweishan 333, Taoyuan, Taiwan, Republic of China.
Graefes Arch Clin Exp Ophthalmol. 2006 Nov;244(11):1485-90. doi: 10.1007/s00417-006-0308-4. Epub 2006 Apr 21.
To report treatment of pediatric patients with cataract, and evaluate the efficiency of different surgical interventions.
This study comprised a consecutive series of pediatric patients with congenital or developing cataract who received surgery between 1993 and 2002 at Chang Gung Memorial Hospital in Taiwan. Patients' demographics, cataract type, presenting symptoms, surgical intervention, postoperative visual acuity, and follow-up refractive changes were recorded.
Three hundred and ninety-nine eyes of 246 children were included; unilateral cataract was present 21.8% of the eyes. The age at surgery was ranged from 1 to 157 months. Eyes were grouped by surgical interventions performed: Group 1 included 98 eyes that had lensectomy. Group 2 included 89 eyes that had lensectomy and secondary intraocular lens implantation. Group 3 included 212 eyes that had lensectomy with primary intraocular implantation. The mean follow up time was 41.3 months. Finally, 23.1% group 1 patients, 42.1% group 2 patients, and 63.4% group 3 patients achieved visual acuity better than 20/60 (P=0.000). Upon analysis with multifactor regression, age at onset (P=0.011) was the only significant factor related to visual outcome. Complications such as after cataract and glaucoma occurred in 21.6% and 5.8% of all patients, respectively.
Intraocular lens implantation for children with congenital or developing cataract is an effective treatment for visual rehabilitation, even for those patients age 2 years and younger.
报告小儿白内障患者的治疗情况,并评估不同手术干预措施的效果。
本研究纳入了1993年至2002年期间在台湾长庚纪念医院接受手术的一系列连续性先天性或发育性白内障小儿患者。记录患者的人口统计学资料、白内障类型、症状表现、手术干预措施、术后视力及随访屈光变化。
纳入246名儿童的399只眼;21.8%的眼为单眼白内障。手术年龄为1至157个月。根据所实施的手术干预措施将眼部分组:第1组包括98只接受晶状体切除术的眼。第2组包括89只接受晶状体切除术及二期人工晶状体植入术的眼。第3组包括212只接受晶状体切除术并一期人工晶状体植入术的眼。平均随访时间为41.3个月。最终,第1组23.1%的患者、第2组42.1%的患者及第3组63.4%的患者视力达到20/60以上(P = 0.000)。经多因素回归分析,发病年龄(P = 0.011)是与视力结果相关的唯一显著因素。后发性白内障和青光眼等并发症分别发生在所有患者的21.6%和5.8%。
对于先天性或发育性白内障患儿,人工晶状体植入术是视力康复的有效治疗方法,即使对于2岁及以下的患儿也是如此。