Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai 200031, China.
Graefes Arch Clin Exp Ophthalmol. 2010 May;248(5):681-6. doi: 10.1007/s00417-010-1310-4. Epub 2010 Feb 17.
To present the visual results and the complications of primary intraocular lens (IOL) implantation in infants aged 6 to 12 months between January 2002 and July 2007.
A total of 26 consecutive eyes, of 16 infants with cataract aged 6 to 12 months, were reviewed in the study. All patients had cataract extraction with anterior and posterior capsulorrhexis combined with anterior vitrectomy and primary hydrophobic acrylic IOL implantation. Six infants (six eyes) had unilateral congenital cataract and ten (20 eyes), bilateral cataract. Visual acuity and complications were recorded throughout the 46.4-month mean follow-up (range 22 to 79 months).
All eyes had primary IOL implantation. The mean best-corrected visual acuity (logMAR) was 0.98 +/- 0.18,0.50 +/- 0.14 and 0.61 +/- 0.25 for unilateral, bilateral and all eyes respectively at the last follow-up. IOLs were implanted in the capsular bag of 25 eyes (96.2%) and in the sulcus of the remaining one eye (3.8%). Seven eyes (26.9%) developed visual axis opacification (VAO), and four eyes required secondary pars plana vitrectomy (PPV). IOL opacification occurred in one eye 54 months after implantation. Late onset open-angle glaucoma developed in one eye, and required trabeculectomy surgery. The predictors of good best-corrected visual acuity (BCVA) included partial cataract, bilateral cataract, absence of strabismus or nystagmus, and good amblyopic treatment. The greatest annual myopic change (5.15 +/- 2.08 D) was observed during the first 12 months after surgery. In unilateral cases, there was no significant difference in the axial length between the cataractous eye and the fellow normal eye both at the time of surgery (P = 0.891) and final follow-up (P = 0.693).
Primary IOL implantation was safe and effective for infantile cataract surgery. Total or unilateral cataract, nystagmus or strabismus, and inadequate amblyopic therapy were predictors of poor BCVA. Significant myopic shifts occurred especially in infants in the first year of surgery. The pseudophakic eye had a similar growth rate, as measured by axial length, to that of the fellow normal eye, in unilateral cases.
介绍 2002 年 1 月至 2007 年 7 月期间 6 至 12 个月龄婴儿行原发性人工晶状体（IOL）植入术的视力结果和并发症。
本研究共纳入 26 只连续眼，来自 16 例 6 至 12 个月龄白内障婴儿。所有患者均接受白内障超声乳化术联合前段玻璃体切除术及原发性疏水性丙烯酸 IOL 植入术。6 例（6 只眼）为单侧先天性白内障，10 例（20 只眼）为双侧白内障。术后平均随访 46.4 个月（22 至 79 个月），记录视力和并发症。
所有患眼均行原发性 IOL 植入术。末次随访时，单侧、双侧和所有眼的最佳矫正视力（logMAR）分别为 0.98 +/- 0.18、0.50 +/- 0.14 和 0.61 +/- 0.25。25 只眼（96.2%）IOL 植入于囊袋内，1 只眼（3.8%）植入于巩膜内。7 只眼（26.9%）发生视力轴混浊（VAO），4 只眼需行二期玻璃体切除术（PPV）。植入术后 54 个月 1 只眼发生 IOL 混浊。1 只眼发生晚期开角型青光眼，需行小梁切除术。良好的最佳矫正视力（BCVA）预测因素包括部分白内障、双侧白内障、无斜视或眼球震颤、弱视治疗良好。术后 12 个月内，眼球的近视变化最大（5.15 +/- 2.08 D）。在单侧病例中，手术时（P = 0.891）和最终随访时（P = 0.693）患眼与对侧正常眼的眼轴长度均无显著差异。
对于婴儿白内障手术，原发性 IOL 植入术是安全有效的。完全白内障、单眼白内障、眼球震颤或斜视、弱视治疗不佳是 BCVA 不良的预测因素。尤其是在术后第一年，婴儿的近视度数变化显著。在单侧病例中，人工晶状体眼的眼轴生长速度与对侧正常眼相似。
