State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
PLoS One. 2013 Jul 29;8(7):e69867. doi: 10.1371/journal.pone.0069867. Print 2013.
Monitoring intraocular pressure (IOP) is essential for pediatric cataract treatment but always difficult due to lack of cooperation in young children. We present the baseline characteristics and the first-year results of a long-term prospective cohort study, which are aimed to determine the relationship of the incidence of ocular hypertension (OH) in children after cataract surgery during the first-year period and the risk of developing late-onset glaucoma. Children were included with the following criteria: they were ≤10 years old and scheduled to undergo cataract surgery with/without intraocular lens implantation; they were compliant with our follow-up protocol, which included monitoring IOP using a Tono-Pen under sedation or anesthesia. Incidence of OH, peak OH value, OH onset time and OH duration within a 12-month period following surgery were measured. In brief, 206 patients (379 eyes) were included and OH developed in 66 of 379 (17.4%) eyes. The mean follow-up period was 14.0±3.2 months (median, 12 months; range, 10-16 months). Moreover, 33 of 196 (16.8%) aphakic eyes and 33 of 183 (18.0%) IOL eyes were diagnosed with OH. The peak OH onset times were at 1-week (34/66, 51.5%) and 1-month (14/66, 21.2%) appointments postsurgery. The peak IOP value in the OH eyes was 29.9±7.5 mmHg (median, 29 mmHg; range, 21-48 mmHg). The duration of OH was 30.9±31.2 days (median, 30 days; range, 3-150 days). OH recurred in 13 eyes with a history of OH diagnosed within 1 month postsurgery (13/54, 24.1%), which needed temporary or long term use of antiglaucoma medications. In conclusion, the incidence of OH in children after cataract surgery was 17.4% during the first-year period. Children who have suffered elevated IOP in the first year after cataract surgery should be followed closely to determine if there is an increased risk of developing late-onset glaucoma.
监测眼内压(IOP)对于小儿白内障治疗至关重要,但由于幼儿合作性差,监测一直很困难。我们介绍了一项长期前瞻性队列研究的基线特征和第一年结果,旨在确定白内障手术后第一年儿童发生高眼压(OH)的发生率与迟发性青光眼发病风险的关系。纳入标准为:年龄≤10 岁,拟行白内障手术合并/不合并人工晶状体植入术;患儿能配合我们的随访方案,即通过镇静或麻醉下的 Tono-Pen 监测 IOP。测量术后 12 个月内 OH 的发生率、OH 的峰值眼压、OH 发病时间和 OH 持续时间。本研究共纳入 206 例(379 只眼)患儿,其中 66 只眼(17.4%)发生 OH。平均随访时间为 14.0±3.2 个月(中位数为 12 个月,范围为 10-16 个月)。此外,196 例无晶状体眼中有 33 只(16.8%)和 183 例人工晶状体眼中有 33 只(18.0%)诊断为 OH。OH 的峰值眼压发生时间为术后 1 周(34/66,51.5%)和 1 个月(14/66,21.2%)。OH 眼的峰值眼压为 29.9±7.5mmHg(中位数为 29mmHg,范围为 21-48mmHg)。OH 的持续时间为 30.9±31.2 天(中位数为 30 天,范围为 3-150 天)。在术后 1 个月内已诊断出 OH 的 13 只眼(13/54,24.1%)中,有 13 只眼再次发生 OH,需要临时或长期使用抗青光眼药物。综上所述,白内障术后儿童在第一年期间发生 OH 的比例为 17.4%。白内障术后 1 年内眼压升高的患儿应密切随访,以确定是否有发生迟发性青光眼的风险增加。