Tadros Dina, Trivedi Rupal H, Wilson M Edward
Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina; Ophthalmology Department, Faculty of Medicine, Tanta University, Egypt.
Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina.
J AAPOS. 2016 Feb;20(1):25-9. doi: 10.1016/j.jaapos.2015.10.010.
To report outcomes after at least 5 years' follow-up of consecutive patients at a single center undergoing unilateral congenital cataract surgery during infancy with primary intraocular lens (IOL) implantation at the time of surgery or undergoing secondary IOL implantation later in childhood.
The medical records of pseudophakic children who received initial cataract surgery before 7 months of age were retrospectively reviewed. Children with acquired cataract, persistent fetal vasculature, congenital glaucoma, or follow-up of <5 years were excluded.
Mean age at time of cataract surgery was 2.7 months in the primary group (n = 13) and 1.9 months in the secondary group (n = 13). Mean age at IOL implantation in the latter group was 4.9 ± 2.2 years. Mean age at final follow-up was 10.7 ± 4.2 years in the primary group and 8.7 ± 3.0 years in the secondary group. Glaucoma surgery was performed in 2 primary group eyes and 1 secondary group eye; it was medically controlled in 2 additional eyes of the latter group. One secondary group eye was diagnosed as glaucoma suspect. Visual axis opacification required surgery in 5 primary group eyes and 2 secondary group eyes before IOL implantation. Unplanned IOL exchange or removal for high myopia was required in 3 primary group eyes and 1 secondary group eye. Strabismus surgery was performed in 3 primary group eyes and 7 secondary group eyes. Median visual acuity at final follow-up was 20/150 in both groups. Refraction at last follow-up was -2.9 ± 3.3 D in the primary and -1.8 ± 2.5 D in the secondary group.
Reoperations were common in both groups over long-term follow-up. Close monitoring for glaucoma is also needed in both groups.
报告在单一中心对婴儿期接受单侧先天性白内障手术且在手术时植入一期人工晶状体（IOL）或在儿童期后期接受二期IOL植入的连续患者进行至少5年随访后的结果。
回顾性分析7个月龄前接受初次白内障手术的人工晶状体眼儿童的病历。排除患有后天性白内障、永存原始玻璃体增生症、先天性青光眼或随访时间不足5年的儿童。
一期手术组（n = 13）白内障手术时的平均年龄为2.7个月，二期手术组（n = 13）为1.9个月。二期手术组IOL植入时的平均年龄为4.9±2.2岁。一期手术组末次随访时的平均年龄为10.7±4.2岁，二期手术组为8.7±3.0岁。一期手术组2只眼和二期手术组1只眼进行了青光眼手术；二期手术组另外2只眼通过药物控制。二期手术组1只眼被诊断为青光眼可疑。在IOL植入前，一期手术组5只眼和二期手术组2只眼因视轴混浊需要手术。一期手术组3只眼和二期手术组1只眼因高度近视需要进行计划外的IOL置换或取出。一期手术组3只眼和二期手术组7只眼进行了斜视手术。两组末次随访时的中位视力均为20/150。末次随访时，一期手术组的屈光度数为-2.9±3.3 D，二期手术组为-1.8±2.5 D。
在长期随访中，两组再次手术都很常见。两组都需要密切监测青光眼。
