Bayoumi Nader Hussien Lutfy
J Pediatr Ophthalmol Strabismus. 2015 Jul-Aug;52(4):213-20. doi: 10.3928/01913913-20150414-11. Epub 2015 Apr 17.
Cataract surgery in children is a difficult entity with possible complications, glaucoma being particularly common. The purpose of this study was to explore the results of surgical intervention for glaucoma after congenital cataract surgery in Alexandria University, Egypt.
The study was a retrospective chart review of 32 children with glaucoma after congenital cataract surgery between 2005 and 2012. Preoperative, operative, and postoperative data were collected. Complications were noted. Success was studied at the end of follow-up.
The study included 41 (36 aphakic, 5 pseudophakic) eyes of 32 children undergoing 57 glaucoma surgical procedures. The mean ± standard deviation age at the time of surgery was 17.2 ± 21.6 months (range: 3.0 to 103.5 months) and the mean follow-up period was 39.1 ± 25.2 months (range: 1 to 75 months). The most common (78%) primary glaucoma surgical procedure was combined trabeculotomy-trabeculectomy with mitomycin C. The mean preoperative intraocular pressure, corneal diameter and thickness, cup-disc ratio, and axial length of the study eyes was 22.3 ± 6.1 mm Hg (range: 10 to 34 mm Hg), 11.4 ± 0.9 mm (range: 10 to 13 mm) and 617.6 ± 66.8 µm (range: 538 to 758 µm), 0.5 ± 0.3 mm (range: 0 to 1 mm), and 22.85 ± 2.75 mm (range: 18.55 to 29.17 mm), respectively, and postoperatively at last follow-up was 11.0 ± 7.3 mm Hg (range: 1 to 36 mm Hg), 11.5 ± 0.9 mm (range: 10 to 13 mm) and 576.8 ± 83.3 µm (range: 461 to 736 µm), 0.4 ± 0.3 mm (range: 0 to 1 mm), and 24.62 ± 2.81 mm (range: 19.70 to 32.81 mm), respectively. Success was reported in 34 (82.9%) eyes. Complications included endophthalmitis, hypotony disc edema, and retinal detachment.
Glaucoma after congenital cataract surgery is a difficult entity, often requiring more than one surgical procedure to control it. Long-term follow-up is mandatory to detect any failure of treatment at any time point and manage accordingly.
儿童白内障手术是一项具有潜在并发症的复杂手术，青光眼尤为常见。本研究旨在探讨埃及亚历山大大学先天性白内障手术后青光眼手术干预的效果。
本研究是一项回顾性病历审查，涉及2005年至2012年间32例先天性白内障手术后发生青光眼的儿童。收集术前、术中及术后数据，并记录并发症情况。随访结束时评估手术成功率。
该研究纳入了32例接受57次青光眼手术的儿童的41只眼（36只无晶状体眼，5只人工晶状体眼）。手术时的平均年龄±标准差为17.2±21.6个月（范围：3.0至103.5个月），平均随访期为39.1±25.2个月（范围：1至75个月）。最常见（78%）的原发性青光眼手术是小梁切开术 - 小梁切除术联合丝裂霉素C。研究眼术前平均眼压、角膜直径和厚度、杯盘比及眼轴长度分别为22.3±6.1 mmHg（范围：10至34 mmHg）、11.4±0.9 mm（范围：10至13 mm）、617.6±66.8 µm（范围：538至758 µm）、0.5±0.3 mm（范围：0至1 mm）和22.85±2.75 mm（范围：18.55至29.17 mm），最后一次随访时术后相应指标分别为11.0±7.3 mmHg（范围：1至36 mmHg）、11.5±0.9 mm（范围：10至13 mm）、576.8±83.3 µm（范围：461至736 µm）、0.4±0.3 mm（范围：0至1 mm）和24.62±2.81 mm（范围：19.70至32.81 mm）。34只眼（82.9%）手术成功。并发症包括眼内炎、低眼压性视盘水肿和视网膜脱离。
先天性白内障手术后的青光眼是一个复杂的问题，通常需要不止一次手术来控制。必须进行长期随访，以便随时发现治疗失败情况并相应处理。
