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儿童白内障的延迟就诊:是否值得进行手术治疗?

Delayed presentation of cataracts in children: are they worth operating upon?

作者信息

Gogate Parikshit, Khandekar Rajiv, Shrishrimal Meghna, Dole Kuldeep, Taras Sudhir, Kulkarni Sucheta, Ranade Satish, Deshpande Madan

机构信息

HV Desai Eye Hospital, Pune, India.

出版信息

Ophthalmic Epidemiol. 2010 Jan-Feb;17(1):25-33. doi: 10.3109/09286580903450338.

Abstract

PURPOSE

Childhood cataract is an important cause of avoidable blindness in children. The study aimed to investigate the outcome of surgery in cataracts with delayed presentation which had been operated upon as new pediatric ophthalmology centers were set up in India.

METHODS

This was a retrospective interventional case series from a community eye care center in Western India. Demographic, surgical, pre-operative and post-operative details were obtained from the patients records and entered into Microsoft excel and statistical analysis conducted using SPSS-11 software (SPSS, Chicago, IL). Vision was tested 6 weeks after surgery. The predictors of good vision (> or =6/18) were identified by regression analysis. If the interval between detection of cataract in children and their presentation for surgery was more than 18 months for developmental and 6 months for congenital the cataract was defined having a delayed presentation.

RESULTS

Five hundred and twenty nine eyes of 437 children aged 2 months to 16 years were operated upon in 2004-2006. Preoperative vision was <3/60 in 405 (76.6%) eyes with cataract. Of these 529, 242 eyes were with delayed presentation of cataract (83 congenital and 149 other). 102 had up to 5 years, 91 had 6-10 years and 49 had >11 yrs delay in presentation. At 6 weeks following surgery, vision was > or = 6/18 in 36/93 (38.7%) of eyes with delayed presenting cataracts, as compared to 94/244 (38.5%) > or =6/18 in those without.

CONCLUSION

Surgery for cataracts with delayed presentation helps to regain functional vision, which can be used for navigation and low vision aids.

摘要

目的

儿童白内障是导致儿童可避免失明的重要原因。本研究旨在调查随着印度新的儿科眼科中心的设立,对就诊延迟的白内障患儿进行手术的效果。

方法

这是一项来自印度西部一个社区眼科护理中心的回顾性干预病例系列研究。从患者记录中获取人口统计学、手术、术前和术后详细信息,并录入微软Excel,使用SPSS - 11软件(SPSS,伊利诺伊州芝加哥)进行统计分析。术后6周进行视力测试。通过回归分析确定视力良好(≥6/18)的预测因素。如果儿童白内障发现与手术就诊之间的间隔时间,发育性白内障超过18个月,先天性白内障超过6个月,则定义为就诊延迟。

结果

2004 - 2006年对437名年龄在2个月至16岁的儿童的529只眼睛进行了手术。405只(76.6%)白内障眼睛术前视力<3/60。在这529只眼中,242只眼睛存在白内障就诊延迟(83只为先天性,149只为其他类型)。102只延迟就诊时间长达5年,91只延迟6 - 10年,49只延迟超过11年。术后6周,延迟就诊白内障眼睛中36/93(38.7%)的视力≥6/18,而未延迟就诊的眼睛中这一比例为94/244(38.5%)≥6/18。

结论

对就诊延迟的白内障进行手术有助于恢复功能性视力,可用于导航和低视力辅助。

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