Sahin Alparslan, Caça Ihsan, Cingü Abdullah Kürşat, Türkcü Fatih Mehmet, Yüksel Harun, Sahin Muhammed, Cinar Yasin, Ari Seyhmus
Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Int J Ophthalmol. 2013 Apr 18;6(2):216-20. doi: 10.3980/j.issn.2222-3959.2013.02.21. Print 2013.
To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery.
Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011. The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular pressure (IOP) ≥26mmHg, as measured on at least two occasions along with corneal or optic nerve changes.
The mean follow-up periods of group 1 and 2 were (60.86±30.95) months (12-123 months) and (62.11±31.29) months (14-115 months) respectively. In group 1, 12 eyes of 8 patients (4.8%) developed glaucoma. None of the patients developed glaucoma after surgery in group 2. The mean age of the patients at the cataract surgery was (2.58±0.90) months (1 month-4 months) and the average period for glaucoma development after surgery was (9.50±4.33) months (4-16 months) in group 1. Three of the 12 glaucomatous eyes were controlled with antiglaucomatous medication and 9 eyes underwent trabeculectomy+mitomycin C surgery. One patient underwent a second trabeculectomy + mitomycin C operation for both of his eyes.
The incidence of glaucoma after pediatric cataract surgery is very low in patients in whom IOL is implanted. The aphakic eyes after pediatric cataract surgery are at an increased risk for glaucoma development particularly if they underwent surgery before 4 months of age.
确定小儿白内障手术后继发性青光眼的发病率及危险因素。
回顾性评估2000年至2011年间148例患者的249只未植入人工晶状体(IOL)的白内障手术眼(第1组),以及129例患者的220只植入IOL的白内障手术眼(第2组)。观察指标为白内障手术后青光眼的发生情况,定义为眼压(IOP)≥26mmHg,且至少两次测量伴有角膜或视神经改变。
第1组和第2组的平均随访时间分别为(60.86±30.95)个月(12 - 123个月)和(62.11±31.29)个月(14 - 115个月)。第1组中,8例患者的l2只眼(4.8%)发生青光眼。第2组术后无患者发生青光眼。第1组白内障手术时患者的平均年龄为(2.58±0.90)个月(1个月 - 4个月),术后发生青光眼的平均时间为(9.50±4.33)个月(4 - 16个月)。12只青光眼眼中,3只通过抗青光眼药物控制,9只眼接受了小梁切除术 + 丝裂霉素C手术。1例患者双眼均接受了二次小梁切除术 + 丝裂霉素C手术。
植入IOL的小儿白内障手术患者青光眼的发病率很低。小儿白内障手术后的无晶状体眼发生青光眼的风险增加,尤其是在4个月龄前接受手术的患者。