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中国东部地区儿童外伤性白内障及其手术结果:一项基于医院的研究。

Pediatric traumatic cataract and surgery outcomes in eastern China: a hospital-based study.

作者信息

Xu Ying-Nan, Huang Yu-Sen, Xie Li-Xin

机构信息

Weifang Medical University, Weifang 261053, Shandong Province, China ; Shandong Eye Institute, Qingdao 266071, Shandong Province, China.

出版信息

Int J Ophthalmol. 2013 Apr 18;6(2):160-4. doi: 10.3980/j.issn.2222-3959.2013.02.10. Print 2013.

Abstract

AIM

To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China.

METHODS

Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis.

RESULTS

A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included in the study. The mean (SEM) age at diagnosis was (6.6±3.2) years (range, 1.3-13.8 years). Each cataract was categorized according to the type of trauma: closed-globe (n=26) or open-globe (n=91) injuries. The most common injuring objects were sharp metal objects (37.61%). The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs) were primarily implanted in 47 eyes (68.12%), whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%). The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision.

CONCLUSION

Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.

摘要

目的

评估中国东部地区儿童外伤性白内障的病因、治疗及预后情况。

方法

回顾性分析儿童外伤性白内障患者的人口统计学信息、损伤类型、致伤方式、受伤时间、受伤至首次就诊间隔时间、首诊医院、手术情况、并发症及预后。

结果

本研究共纳入117例患者的117只眼(96例男孩,21例女孩),均为单眼损伤(右眼66只,左眼51只)。诊断时的平均(标准误)年龄为(6.6±3.2)岁(范围1.3 - 13.8岁)。每例白内障根据外伤类型分类:闭合眼球伤(n = 26)或开放性眼球伤(n = 91)。最常见的致伤物是尖锐金属物体(37.61%)。开放性眼球伤最常见的并发症是角膜裂伤,而闭合性眼球伤最常见的是外伤性瞳孔散大。68例开放性眼球伤患者接受白内障摘除术,其中47只眼(68.12%)一期植入人工晶状体;18例闭合性眼球伤患者接受白内障摘除术,17只眼(94.4%)一期植入人工晶状体。手术操作包括前段重建、粘连松解、膜切除、晶状体切除术、玻璃体切除术及相关技术。术后视力较术前显著提高。

结论

儿童外伤性白内障应及时治疗以减少并发症,且需要开展儿童外伤性白内障相关教育并改善儿童医疗保健,以早期发现儿童白内障。

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