Baradaran-Rafii Alireza, Shirzadeh Ebrahim, Eslani Medi, Akbari Mitra
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Sabzevar University of Medical Sciences, Sabzevar, Iran.
J Ophthalmic Vis Res. 2014 Jan;9(1):71-82.
There are several reasons for which the correction of aphakia differs between children and adults. First, a child's eye is still growing during the first few years of life and during early childhood, the refractive elements of the eye undergo radical changes. Second, the immature visual system in young children puts them at risk of developing amblyopia if visual input is defocused or unequal between the two eyes. Third, the incidence of many complications, in which certain risks are acceptable in adults, is unacceptable in children. The optical correction of aphakia in children has changed dramatically however, accurate optical rehabilitation and postoperative supervision in pediatric cases is more difficult than adults. Treatment and optical rehabilitation in pediatric aphakic patients remains a challenge for ophthalmologists. The aim of this review is to cover issues regarding optical correction of pediatric aphakia in children; kinds of optical correction , indications, timing of intraocular lens (IOL) implantation, types of IOLs, site of implantation, IOL power calculations and selection, complications of IOL implantation in pediatric patients and finally to determine the preferred choice of optical correction. However treatment of pediatric aphakia is one step on the long road to visual rehabilitation, not the end of the journey.
儿童和成人无晶状体矫正存在差异有几个原因。首先,儿童的眼睛在生命的最初几年仍在生长,在幼儿期,眼睛的屈光元件会发生根本性变化。其次,如果两只眼睛的视觉输入散焦或不均衡,幼儿未成熟的视觉系统会使他们有患弱视的风险。第三,许多并发症的发生率在成人中某些风险可接受,但在儿童中却不可接受。然而,儿童无晶状体的光学矫正已经发生了巨大变化,儿科病例的精确光学康复和术后监测比成人更困难。儿科无晶状体患者的治疗和光学康复对眼科医生来说仍然是一个挑战。本综述的目的是涵盖儿童无晶状体光学矫正的相关问题;光学矫正的种类、适应证、人工晶状体(IOL)植入时机、IOL类型、植入部位、IOL屈光度计算与选择、儿科患者IOL植入的并发症,最后确定光学矫正的首选方案。然而,儿科无晶状体的治疗只是视觉康复漫长道路上的一步,而非终点。