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儿童后房型虹膜夹型人工晶状体植入术。

Posterior iris-claw aphakic intraocular lens implantation in children.

机构信息

Department of Ophthalmology, Charité, University Medicine Berlin, Berlin, Germany.

出版信息

Am J Ophthalmol. 2013 Aug;156(2):382-386.e1. doi: 10.1016/j.ajo.2013.03.002. Epub 2013 May 27.

Abstract

PURPOSE

To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in children.

DESIGN

Noncomparative retrospective cohort study.

METHODS

setting: Institutional practice. patients/intervention procedures: Seven eyes of 4 children without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2007 and 2012. main outcome measures: Visual acuity, endothelial cell changes, intraoperative and postoperative complications.

RESULTS

The mean age of the 3 boys and 1 girl was 12.0 ± 3.4 (SD) years (range 8-16 years). In all eyes, the mean postoperative best spectacle-corrected visual acuity (0.13 ± 0.17 logMAR) was statistically significantly better at the last follow-up than at 1 day preoperatively (0.60 ± 0.39 logMAR) (P < .05). The mean follow-up was 31 months (range 10-64 months). The mean endothelial cell density decreased from 3013 ± 155 cells/mm(2) preoperatively to 2831 ± 236 cells/mm(2) at last follow-up, representing a mean endothelial cell loss of 6.4%. No corneal decompensation, iritis, secondary glaucoma, or pupillary block occurred after surgery in any eye. Postoperative complications included transient postoperative hypotony in 1 eye and a traumatic dislocation of a posterior aphakic iris-claw IOL in 1 eye.

CONCLUSION

The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative for a wide range of indications in pediatric eyes without adequate capsular support.

摘要

目的

评估儿童后房型虹膜夹型人工晶状体(IOL)植入的适应证、视力结果和并发症发生率。

设计

非对照回顾性队列研究。

方法

机构实践。

患者/干预措施:2007 年至 2012 年间,4 名儿童的 7 只眼因缺乏足够的囊袋支持而接受后房型虹膜夹型无晶状体 IOL 植入。

主要观察指标

视力、内皮细胞变化、术中及术后并发症。

结果

3 名男孩和 1 名女孩的平均年龄为 12.0 ± 3.4(SD)岁(8-16 岁)。所有眼的平均术后最佳矫正视力(0.13 ± 0.17 logMAR)在末次随访时明显优于术前 1 天(0.60 ± 0.39 logMAR)(P<.05)。平均随访时间为 31 个月(10-64 个月)。平均内皮细胞密度从术前的 3013 ± 155 个/平方毫米降至末次随访时的 2831 ± 236 个/平方毫米,代表平均内皮细胞丢失 6.4%。术后无任何眼发生角膜失代偿、虹膜炎、继发性青光眼或瞳孔阻滞。术后并发症包括 1 只眼短暂性术后低眼压和 1 只眼后房型无晶状体虹膜夹型 IOL 外伤性脱位。

结论

无晶状体虹膜夹型 IOL 的后房型植入技术提供了良好的视力结果,并发症发生率低,可作为无足够囊袋支持的儿童眼广泛适应证的合理替代方法。

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