Schulze Schwering M, Msukwa G, Spitzer M S, Kalua K
Universitätsaugenklinik Tübingen, Schleichstr. 16, 72076, Tübingen, Deutschland,
Ophthalmologe. 2014 Apr;111(4):348-53. doi: 10.1007/s00347-013-2872-4.
The aim of this study was to evaluate the postoperative refractive status after pediatric cataract surgery with age-determined intraocular lens (IOL) implantation in children (age 0-8 years) in Malawi.
Hospital-based retrospective study from January to June 2011 analyzing age, sex, origin, type of cataract surgery, IOL power and postoperative refractive status. In the absence of biometry, IOL powers were chosen according to the child's age and IOL availability.
A total of 58 eyes from 33 children were surgically treated of which 25 (76%) were bilateral and 8 (24%) unilateral. Best refractive outcome was achieved with a 25 diopter (D) IOL implanted in children 5-8 years old. None of the children aged 1-7 years achieved the previously calculated target refraction. Results showed a marked myopic variability. The range of postoperative refraction was from - 15 D to + 12.5 D and a large number of children (n=11, 33%) did not attend for follow-up.
Implanting IOLs according to age groups is not a suitable surgical strategy even in resource-poor settings. Refractive outcomes were too variable with a marked myopic shift. Biometry and keratometry are required in order to undertake pediatric cataract surgery. Developing regional pediatric centres should be a focus of the VISION 2020 initiative.
本研究旨在评估在马拉维对0至8岁儿童进行年龄决定型人工晶状体（IOL）植入的小儿白内障手术后的屈光状态。
2011年1月至6月进行的一项基于医院的回顾性研究，分析年龄、性别、来源、白内障手术类型、人工晶状体度数及术后屈光状态。在无法进行生物测量时，根据儿童年龄和人工晶状体的可获得性选择人工晶状体度数。
共对33名儿童的58只眼睛进行了手术治疗，其中25只（76%）为双眼，8只（24%）为单眼。对5至8岁儿童植入25屈光度（D）的人工晶状体可获得最佳屈光效果。1至7岁的儿童均未达到预先计算的目标屈光度。结果显示出明显的近视变异性。术后屈光度范围为-15 D至+12.5 D，大量儿童（n = 11，33%）未进行随访。
即使在资源匮乏地区，按年龄组植入人工晶状体也不是合适的手术策略。屈光结果差异太大，且有明显的近视偏移。进行小儿白内障手术需要生物测量和角膜曲率测量。发展区域小儿中心应成为“视觉2020”倡议的重点。
