Wood K S, Tadros D, Trivedi R H, Wilson M E
Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, SC, USA.
Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Eye (Lond). 2016 Sep;30(9):1182-6. doi: 10.1038/eye.2016.131. Epub 2016 Jul 1.
PurposeThe purpose of this study was to determine the long-term complications and outcomes of secondary intraocular lens (IOL) implantation in patients with congenital cataracts.Patients and MethodsThe medical records of children operated for secondary IOL implantation surgery between 2000 and 2014 were retrospectively reviewed. Those who had undergone their initial congenital cataract surgery before 7 months of age were included and were analyzed for intra- and postoperative factors and postoperative refractive outcomes. We focused on three complications: visual axis opacification (VAO), glaucoma, and IOL exchange after at least 1 year of follow-up.ResultsA total of 49 eyes of 49 patients were analyzed for intraoperative indications. Of those, 37 eyes of 37 patients had at least 1 year of follow-up and were analyzed for postoperative outcomes. The mean age at secondary implantation was 55.2±21.6 months. At secondary implantation, 69.4% of eyes were implanted in the capsular bag, 28.6% in the sulcus, and 2.0% that were angle-supported. There was no significant correlation between the site of secondary IOL implantation and age at implantation (P=0.216). The mean follow-up after implantation was 57.6±33.6 months. The rate of VAO was 5.4%, the rate of glaucoma occurring after secondary implantation was 16.2%, and the rate of IOL exchange was 2.7%. The median visual acuity at final follow-up was 20/40. For patients with unilateral cataracts it was 20/60 and for bilateral patients it was 20/30.ConclusionsThe secondary IOL implantation in children is a relatively safe procedure associated with low rates of postoperative complications. Visual outcomes are acceptable and are better for bilateral patients than for unilateral patients.
目的
本研究的目的是确定先天性白内障患者二期人工晶状体（IOL）植入的长期并发症及预后情况。
患者与方法
回顾性分析2000年至2014年期间接受二期IOL植入手术患儿的病历。纳入那些在7个月龄之前接受初次先天性白内障手术的患儿，并分析其术中及术后因素以及术后屈光结果。我们重点关注三种并发症：视轴混浊（VAO）、青光眼以及随访至少1年后的IOL置换。
结果
共对49例患者的49只眼进行了术中指征分析。其中，37例患者的37只眼进行了至少1年的随访，并分析了术后结果。二期植入时的平均年龄为55.2±21.6个月。二期植入时，69.4%的眼植入于囊袋内，28.6%植入于睫状沟，2.0%为前房角支撑型。二期IOL植入部位与植入时年龄之间无显著相关性（P = 0.216）。植入后的平均随访时间为57.6±33.6个月。VAO发生率为5.4%，二期植入后发生青光眼的发生率为16.2%，IOL置换率为2.7%。末次随访时的中位视力为20/40。单眼白内障患者为20/60，双眼患者为20/30。
结论
儿童二期IOL植入是一种相对安全的手术，术后并发症发生率较低。视力预后可以接受，双眼患者的视力预后优于单眼患者。
