Wong I B Y, Sukthankar V D, Cortina-Borja M, Nischal K K
Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London , UK.
Br J Ophthalmol. 2009 Sep;93(9):1200-3. doi: 10.1136/bjo.2008.155200. Epub 2009 May 7.
To determine the incidence of glaucoma, with onset within 1 year after the date of cataract surgery (early onset) performed in the first year of life, with or without intraocular lens (IOL) implantation.
A retrospective review of a single surgeon's cohort from 1999 to 2006. Glaucoma onset risk, comparison of aphakic/pseudophakic eyes and IOL type were analysed together with microcornea, persistent fetal vasculature (PFV) and age < or =4 weeks at surgery.
Ninety-eight eyes (62 patients; mean age 2.88 months) were included with 61 eyes (36 patients) aphakic (57 planned and four failed implantations), and 37 eyes (26 patients) pseudophakic. At a mean follow-up of 2.51 years,15.3% (12.2% within 1 year) of all eyes, 9.8% of eyes (6.6% within 1 year) in the planned aphakic group, all four eyes with failed implantation and 13.5% of the pseudophakic eyes (10.8% within 1 year) developed glaucoma. Glaucoma incidence stratified by absence or presence of IOL showed no statistically significant difference, but eyes in the rigid polymethylmethacrylate group had an increased glaucoma risk compared with the Acrysof group (p = 0.002). Microcornea, PFV and age < or =4 weeks at surgery were not significant predictors of early-onset glaucoma.
In this single surgeon study of infant cataract surgery only, age < or =4 weeks at surgery was not a predictor of early-onset glaucoma. The rate of aphakic and pseudophakic early-onset glaucoma was not found to be statistically different, but we found a statistically different rate of glaucoma between the two IOL types which needs further evaluation, given that this is a retrospective review. Excessive surgical trauma influences incidence of glaucoma.
确定在出生后第一年进行白内障手术（早发性）后1年内发病的青光眼的发生率，无论是否植入人工晶状体（IOL）。
对1999年至2006年单一外科医生的队列进行回顾性研究。分析青光眼发病风险、无晶状体/人工晶状体眼的比较以及IOL类型，并结合小角膜、永存原始玻璃体（PFV）和手术时年龄≤4周进行分析。
纳入98只眼（62例患者；平均年龄2.88个月），其中61只眼（36例患者）为无晶状体眼（57例计划植入和4例植入失败），37只眼（26例患者）为人工晶状体眼。平均随访2.51年，所有眼中15.3%（1年内为12.2%）、计划无晶状体组中9.8%的眼（1年内为6.6%）、所有4例植入失败的眼以及人工晶状体眼中13.5%（1年内为10.8%）发生了青光眼。按是否存在IOL分层的青光眼发生率无统计学显著差异，但与丙烯酸酯人工晶状体组相比，硬性聚甲基丙烯酸甲酯组的眼发生青光眼的风险增加（p = 0.002）。小角膜、PFV和手术时年龄≤4周不是早发性青光眼的显著预测因素。
在这项仅针对婴儿白内障手术的单一外科医生研究中，手术时年龄≤4周不是早发性青光眼的预测因素。未发现无晶状体和人工晶状体早发性青光眼的发生率在统计学上有差异，但鉴于这是一项回顾性研究，我们发现两种IOL类型之间的青光眼发生率在统计学上有差异，需要进一步评估。过度的手术创伤会影响青光眼的发生率。
