Zhang Hui, Xie Li-xin
Shandong Academy of Medical Sciences, Qingdao, China.
Zhonghua Yan Ke Za Zhi. 2013 Feb;49(2):134-8.
To observe the rate of secondary glaucoma after pediatric congenital cataract surgery in the first 36 months of life.
Retrospective case series. The records of children who underwent surgery for congenital cataract within the first 36 months of life between July 1995 and July 2005 at Qingdao Eye Hospital were reviewed. Children with preoperative conditions associated with glaucoma were excluded. Age at surgery, unilateral or bilateral cataract, type of congenital cataract, primary intraocular lens (IOL) insertion, duration of follow-up, postoperative best corrected visual acuity, development of aphakic glaucoma, and development of glaucoma after secondary IOL implantation were evaluated.
A total of 115 patients (204 eyes) with an average surgery age of (12.5 ± 9.2) months were included; the mean follow-up time was (83.7 ± 43.8) months. 15 eyes (11 patients) (7.4%) had subsequent development of glaucoma, 7 of which (4 patients) developed late-onset open-angle glaucoma. Of the 15 eyes, 13 eyes had surgery within 9 months, and 12 eyes developed nuclear or total cataract. None of the primarily pseudophakia eyes developed glaucoma in our study. Of 86 eyes that received implantation of secondary intraocular lens in the ciliary sulcus, 13 eyes (15.1%) developed pseudophakia glaucoma.
Secondary glaucoma occurred after pediatric bilateral cataract surgery. As late-onset glaucoma usually occurred several years after primary surgery, long-time follow-up after pediatric cataract surgery needs to be emphasized.
观察出生后36个月内小儿先天性白内障手术后继发性青光眼的发生率。
回顾性病例系列研究。对1995年7月至2005年7月在青岛眼科医院接受出生后36个月内先天性白内障手术的患儿记录进行回顾。排除术前有青光眼相关情况的患儿。评估手术年龄、单侧或双侧白内障、先天性白内障类型、一期人工晶状体植入、随访时间、术后最佳矫正视力、无晶状体性青光眼的发生情况以及二期人工晶状体植入后青光眼的发生情况。
共纳入115例患者(204只眼),平均手术年龄为(12.5±9.2)个月;平均随访时间为(83.7±43.8)个月。15只眼(11例患者)(7.4%)随后发生青光眼,其中7只眼(4例患者)发生迟发性开角型青光眼。在这15只眼中,13只眼在9个月内接受了手术,12只眼为核性或完全性白内障。在本研究中,一期人工晶状体眼均未发生青光眼。在86只在睫状沟植入二期人工晶状体的眼中,13只眼(15.1%)发生了人工晶状体性青光眼。
小儿双侧白内障手术后发生继发性青光眼。由于迟发性青光眼通常在初次手术后数年发生,因此需要强调小儿白内障手术后的长期随访。