Mataftsi Asimina
2nd Department of Ophthalmology, Paediatric Ophthalmology and Strabismus, Medical School, Aristotle University of Thessaloniki, 'Papageorpiou' Hospital, Thessaloniki, Greece.
Dev Ophthalmol. 2016;57:40-8. doi: 10.1159/000442500. Epub 2016 Apr 1.
Postoperative glaucoma is perhaps the most feared complication after paediatric cataract surgery, as it is difficult to control. Paediatric glaucoma is also challenging to diagnose, and different definitions of glaucoma have led to a rather big range of reported incidences of this disease. It can occur soon after surgery, in which case it is usually closed-angle glaucoma, or it can have a late onset, even more than a decade after surgery, and its aetiopathogenesis remains unclear to this day. There is significant controversy as to what the risk factors are for developing it, especially regarding intraocular lens implantation. The vast majority of studies show that an earlier age at surgery confers a higher risk. Medical and surgical treatment of aphakic/pseudophakic glaucoma can be successful; however, management often requires repeated procedures with or without multiple medications, and the prognosis is guarded. The visual outcome depends on sufficient intraocular pressure control and management of concurrent amblyopia.
术后青光眼可能是小儿白内障手术后最令人担忧的并发症,因为它难以控制。小儿青光眼的诊断也具有挑战性,而且青光眼的不同定义导致该疾病的报告发病率范围相当大。它可在手术后不久发生,这种情况下通常是闭角型青光眼,或者它也可能延迟发作,甚至在手术后十多年才出现,其发病机制至今仍不清楚。关于发生术后青光眼的危险因素是什么存在重大争议,尤其是在人工晶状体植入方面。绝大多数研究表明,手术时年龄越小,风险越高。无晶状体/人工晶状体性青光眼的药物和手术治疗可能会成功;然而,治疗通常需要反复进行手术或使用多种药物,而且预后并不乐观。视力结果取决于眼内压的充分控制以及同时存在的弱视的治疗。