Shenoy Bhamy Hariprasad, Mittal Vaibhev, Gupta Amit, Sachdeva Virender, Kekunnaya Ramesh
Jasti V. Ramanamma Children's Eye Care Center, Kallam Anji Reddy Campus, L.V. Prasad Eye Institute, Hyderabad, India.
Nimagadda Prasad Children's Eye Center, GMRV Campus, L.V. Prasad Eye Institute, Visakapatnam, India.
Am J Ophthalmol. 2015 Apr;159(4):720-6. doi: 10.1016/j.ajo.2015.01.002. Epub 2015 Jan 9.
To evaluate safety and visual outcomes in surgically aphakic children undergoing secondary intraocular lens (IOL) implantation.
Retrospective, consecutive, interventional case series.
One hundred seventy-four eyes of 104 children (70 bilateral, 34 unilateral) who underwent secondary IOL implantation for aphakia after congenital cataract surgery at L. V. Prasad Eye Institute, Hyderabad, India, were analyzed. A minimum of 3 months of follow-up after surgery was required for inclusion in the study. Eyes with aphakia after surgery for traumatic cataracts and other associated ocular comorbidities were excluded. Main outcome measures were intraoperative and postoperative complications and visual outcome at the last follow-up.
Mean age at secondary IOL implantation was 6.08 ± 3.75 years. The mean follow-up was 25.7 ± 24.9 months. Mean best-corrected visual acuity improved from 1.08 ± 0.65 in aphakic children to 0.55 ± 0.51 logarithm of the minimal angle of resolution in pseudophakic children at last follow-up (P < .0001). Overall, 51 eyes (35%) attained a final best-corrected visual acuity of 20/40 (0.3 logarithm of the minimal angle of resolution) or better, whereas only 2 eyes (8.7%) attained a final best-corrected visual acuity of 20/40 (0.3 logarithm of the minimal angle of resolution) or better in children who underwent secondary IOL implantation for unilateral aphakia. The most common postoperative complications were secondary membrane formation (17 eyes; 9.77%), optic capture (15 eyes; 8.6%), IOL decentration (9 eyes; 5.17%), and secondary glaucoma (11 eyes; 5%).
Secondary sulcus IOL implantation in children is a relatively safe procedure and leads to favorable visual postoperative outcomes.
评估接受二期人工晶状体（IOL）植入手术的无晶状体儿童的安全性和视觉效果。
回顾性、连续性、干预性病例系列研究。
对印度海得拉巴市L.V.普拉萨德眼科研究所104名接受先天性白内障手术后二期IOL植入的儿童（70例双侧，34例单侧）的174只眼睛进行分析。纳入研究的患者术后至少需随访3个月。外伤性白内障手术后出现无晶状体以及合并其他眼部疾病的眼睛被排除。主要观察指标为术中及术后并发症以及最后一次随访时的视觉效果。
二期IOL植入时的平均年龄为6.08±3.75岁。平均随访时间为25.7±24.9个月。最后一次随访时，无晶状体儿童的平均最佳矫正视力从1.08±0.65提高到了人工晶状体眼儿童的0.55±0.51最小分辨角对数（P<0.0001）。总体而言，51只眼睛（35%）最终最佳矫正视力达到20/40（最小分辨角对数0.3）或更好，而单侧无晶状体接受二期IOL植入的儿童中，只有2只眼睛（8.7%）最终最佳矫正视力达到20/40（最小分辨角对数0.3）或更好。最常见的术后并发症是继发性膜形成（17只眼睛；9.77%）、光学捕获（15只眼睛；8.6%）、IOL偏心（9只眼睛；5.17%）和继发性青光眼（11只眼睛；5%）。
儿童二期沟内IOL植入是一种相对安全的手术，术后视觉效果良好。
