儿童晶状体囊袋内人工晶状体植入术：长期随访
Pediatric bag-in-the-lens intraocular lens implantation: long-term follow-up.
作者信息
Van Looveren Jan, Ní Dhubhghaill Sorcha, Godts Daisy, Bakker Ellen, De Veuster Ilse, Mathysen Danny G P, Tassignon Marie-José
机构信息
From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
出版信息
J Cataract Refract Surg. 2015 Aug;41(8):1685-92. doi: 10.1016/j.jcrs.2014.12.057.
PURPOSE
To evaluate long-term follow-up results of pediatric cataract surgery using the bag-in-the-lens (BIL) intraocular lens (IOL) implantation technique.
SETTING
Antwerp University Hospital, Edegem, Antwerp, Belgium.
DESIGN
Prospective case series.
METHODS
All pediatric cataract surgeries with BIL IOL implantation performed at the Antwerp University Hospital were evaluated. Only cases that completed a follow-up of 5 years at the hospital's Department of Ophthalmology were included in this study.
RESULTS
Forty-six eyes of 31 children had a complete follow-up of 5 years or more after BIL IOL implantation. Sixteen cases were unilateral and 15 were bilateral. Patient age at time of surgery ranged from 2 months to 14 years. The mean refraction at the end of follow-up was -1.99 diopters (D) ± 3.70 (SD). In bilateral cases, a corrected distance visual acuity (CDVA) of better than 0.5 was attained in 86.7% and a CDVA of 1.0 was achieved in 56.7%. In unilateral cases, 31.2% achieved a CDVA of better than 0.5 but none obtained a CDVA of 1.0. A clear visual axis was maintained in 91.3% of cases during follow-up. Visual axis reopacification was detected in 4 eyes of 3 cases, all due to inadequate BIL IOL positioning. None of these eyes needed more than 1 intervention to maintain visual axis clarity. Other than 1 case of glaucoma, no severe complications were detected.
CONCLUSION
Long-term follow-up results show that BIL IOL implantation is a safe, well-tolerated approach for treating pediatric cataract with a very low rate of visual axis reopacification and a low rate of secondary interventions for other postoperative complications.
FINANCIAL DISCLOSURE
Dr. Tassignon has intellectual property rights to the bag-in-the-lens intraocular lens (U.S. patent 6 027 531; EU patent 009406794.PCT/120268), which is licensed to Morcher GmbH, Stuttgart, Germany. No other author has a financial or proprietary interest in any material or method mentioned.
目的
评估采用晶状体囊袋内植入（BIL）人工晶状体（IOL）植入技术进行小儿白内障手术的长期随访结果。
地点
比利时安特卫普埃代海姆的安特卫普大学医院。
设计
前瞻性病例系列研究。
方法
对在安特卫普大学医院进行的所有采用BIL IOL植入的小儿白内障手术进行评估。本研究仅纳入在医院眼科完成5年随访的病例。
结果
31例儿童的46只眼在BIL IOL植入后进行了5年或更长时间的完整随访。16例为单眼，15例为双眼。手术时患者年龄为2个月至14岁。随访结束时的平均屈光度为-1.99屈光度（D）±3.70（标准差）。在双眼病例中，86.7%的患者矫正远视力（CDVA）优于0.5，56.7%的患者CDVA达到1.0。在单眼病例中，31.2%的患者CDVA优于0.5，但无一例患者CDVA达到1.0。随访期间91.3%的病例保持了清晰的视轴。在3例患者的4只眼中检测到视轴再混浊，均因BIL IOL定位不当所致。这些眼中无一例需要超过1次干预来维持视轴清晰。除1例青光眼外，未检测到严重并发症。
结论
长期随访结果表明，BIL IOL植入是一种安全、耐受性良好的治疗小儿白内障的方法，视轴再混浊发生率极低，其他术后并发症的二次干预率也很低。
财务披露
塔西农博士对晶状体囊袋内人工晶状体拥有知识产权（美国专利6027531；欧盟专利009406794.PCT/120268），该专利已授权给德国斯图加特的莫尔彻有限公司。其他作者对文中提及的任何材料或方法均无财务或专有权益。
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