印度农村儿童外伤性白内障的病因、流行病学和长期结局。
Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India.
机构信息
Lions NAB Eye Hospital, Miraj, Sangli District, Maharashtra, India.
出版信息
Indian J Ophthalmol. 2012 Sep-Oct;60(5):481-6. doi: 10.4103/0301-4738.100557.
PURPOSE
To describe preoperative factors, long-term (>3 years) postoperative outcome and cost of traumatic cataracts in children in predominantly rural districts of western India. Subjects : Eighty-two traumatic cataracts in 81 children in a pediatric ophthalmology department of a tertiary eye-care center.
MATERIALS AND METHODS
Traumatic cataracts operated in 2004-2008 were reexamined prospectively in 2010-2011 using standardized technique. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded.
STATISTICAL ANALYSIS
Data analysis done by using SPSS (Statistical package for social sciences) version 17.0 We have used Chi-square test, Fisher's exact test, paired t-test to find the association between the final vision and various parameters at 5% level of significance; binary logistic regression was performed for visual outcome ≥6/18 and ≥6/60.
RESULTS
The children were examined in a 3-7 year follow-up (4.35 ± 1.54). Average age at time of surgery was 10.4 ± 4.43 years (1.03 to 18). Fifty (61.7%) were boys. Forty (48.8%) were blunt and 32 (39%) were sharp trauma. The most common cause was wooden stick 23 (28.0%) and sharp thorn 14 (17.1%). Delay between trauma and presentation to hospital ranged from same day to 12 years after the injury with median of 4 days. The mean preoperative visual acuity by decimal notation was 0.059 ± 0.073 and mean postoperative visual acuity was 0.483 ± 0.417 (P < 0.001). Thirty-eight (46.3%) had best corrected visual acuity (BCVA) ≥6/18 and 51 (62.2%) had BCVA ≥ 6/60. In univariable analysis, visual outcome (≥6/18) depended on type of surgery (P = 0.002), gender (P = 0.028), and type of injury (P = 0.07)-sharp trauma and open globe injury had poorer outcomes; but not on age of child, preoperative vision, and type of surgeon. On multivariable binary logistic regression, only gender was significant variable. Of the 82 eyes, 18 (22%) needed more than one surgery. The parents spent an average of Rs. 2250 ($45) for the surgery and 55 (66.4%) were from lower socio-economic class.
CONCLUSION
The postoperative visual outcomes varied and less than half achieved ≥ 6/18.
目的
描述在印度西部主要农村地区儿童外伤性白内障的术前因素、长期（>3 年）术后结果和成本。
对象
2004-2008 年在一家三级眼科护理中心的小儿眼科部门接受手术的 81 名儿童中的 82 例外伤性白内障。
材料与方法
对 2010-2011 年使用标准化技术进行前瞻性复查。记录创伤的原因和类型、人口统计学因素、手术干预、并发症和视力。
统计学分析
使用 SPSS（社会科学统计软件包）版本 17.0 进行数据分析。在 5%的显著性水平上，我们使用卡方检验、Fisher 确切检验、配对 t 检验来发现最终视力与各种参数之间的关联；使用二元逻辑回归分析视力≥6/18 和≥6/60 的结果。
结果
儿童在 3-7 年的随访期内（4.35±1.54）接受检查。手术时的平均年龄为 10.4±4.43 岁（1.03-18 岁）。50 名（61.7%）为男孩。40 名（48.8%）为钝挫伤，32 名（39%）为锐器伤。最常见的原因是木棍子 23 名（28.0%）和尖锐刺 14 名（17.1%）。创伤和到医院就诊之间的时间延迟从受伤当天到 12 年不等，中位数为 4 天。术前十进制视力均值为 0.059±0.073，术后视力均值为 0.483±0.417（P<0.001）。38 名（46.3%）有最佳矫正视力（BCVA）≥6/18，51 名（62.2%）有 BCVA≥6/60。在单变量分析中，视力结果（≥6/18）取决于手术类型（P=0.002）、性别（P=0.028）和损伤类型（P=0.07）-锐器伤和开放性眼球损伤的结果较差；但与儿童年龄、术前视力和手术医生类型无关。在多变量二元逻辑回归中，只有性别是显著变量。在 82 只眼中，18 只（22%）需要进行多次手术。父母为手术平均花费 2250 卢比（45 美元），55 名（66.4%）来自较低社会经济阶层。
结论
术后视力结果不同，不到一半的人达到≥6/18。
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