Vasavada Viraj A, Dixit Nirmit V, Ravat Farida A, Praveen Mamidipudi R, Shah Sajani K, Vasavada Vaishali, Vasavada Abhay R, Trivedi Rupal H
Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India.
J Cataract Refract Surg. 2009 Mar;35(3):519-28. doi: 10.1016/j.jcrs.2008.11.031.
To report the intraoperative performance and postoperative outcomes in microphthalmic eyes of infants younger than 1 year having bilateral cataract surgery.
Iladevi Cataract & IOL Research Centre, Ahmedabad, India.
This prospective observational study excluded eyes with ocular trauma, inflammation, posterior persistent fetal vasculature causing stretching of the ciliary processes or tractional retinal detachment, aniridia, or chorioretinal coloboma. Intraoperative observations included the rate of peripheral extension of the anterior capsule tear, intraoperative iris prolapse/trauma, and posterior capsule tear. All eyes were left aphakic. Postoperative observations included visual outcome, posterior synechias, visual axis obscuration (VAO), and glaucoma.
The study evaluated 42 eyes of 21 infants. The mean age at surgery was 4.0 months +/- 2.6 (SD) and the mean follow-up, 25.6 +/-11.3 months. Surgery was performed using the limbal approach in 30 eyes (71.4%) and by pars plicata lensectomy in 12 eyes (28.6%). In the limbal group, 3 eyes (10.0%) had an incomplete anterior capsulorhexis, 2 eyes (6.7%) had iris trauma, and 2 eyes (6.7%) had peripheral extension of the posterior capsulectomy edge. At the final follow-up, visual acuity remained stable in 4 eyes (9.5%) and was improved in 38 eyes (90.5%). The complications were posterior synechias in 15 eyes (35.7%), glaucoma in 13 eyes (30.9%), and VAO in 7 eyes (16.7%).
The results suggest that good visual outcomes can be obtained in microphthalmic patients with bilateral congenital cataract after early surgical intervention, with an acceptable rate of serious postoperative complications.
报告1岁以下双侧白内障手术患儿小眼球的术中表现及术后结果。
印度艾哈迈达巴德的伊拉德维白内障与人工晶状体研究中心。
这项前瞻性观察性研究排除了有眼外伤、炎症、导致睫状突拉伸或牵引性视网膜脱离的永存原始玻璃体增生症、无虹膜或脉络膜视网膜缺损的眼睛。术中观察包括前囊撕开的周边延伸率、术中虹膜脱垂/损伤以及后囊撕开。所有眼睛均保持无晶状体状态。术后观察包括视力结果、虹膜后粘连、视轴遮挡（VAO）和青光眼。
该研究评估了21例婴儿的42只眼睛。手术时的平均年龄为4.0个月±2.6（标准差），平均随访时间为25.6±11.3个月。30只眼睛（71.4%）采用角膜缘入路进行手术，12只眼睛（28.6%）采用睫状体平坦部晶状体切除术。在角膜缘组中，3只眼睛（10.0%）前囊撕囊不完全，2只眼睛（6.7%）有虹膜损伤，2只眼睛（6.7%）后囊切除边缘有周边延伸。在最后一次随访时，4只眼睛（9.5%）视力保持稳定，38只眼睛（90.5%）视力有所改善。并发症包括15只眼睛（35.7%）出现虹膜后粘连，13只眼睛（30.9%）出现青光眼，7只眼睛（16.7%）出现视轴遮挡。
结果表明，早期手术干预后，双侧先天性白内障的小眼球患者可获得良好的视力结果，术后严重并发症发生率可接受。
