Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
J Formos Med Assoc. 2017 Dec;116(12):940-945. doi: 10.1016/j.jfma.2017.01.009. Epub 2017 Feb 21.
BACKGROUND/PURPOSE: To evaluate outcomes in pediatric patients undergoing lensectomy, posterior capsulotomy, and triamcinolone-assisted vitrectomy for congenital cataract.
This retrospective study included 34 patients younger than 72 months who underwent lensectomy, posterior capsulotomy, and triamcinolone-assisted vitrectomy with or without intraocular lens (IOL) implantation for cataract at the National Taiwan University Hospital from July 2006 to December 2012.
Fifty-one eyes from 34 patients with cataract (unilateral in 17 patients, bilateral in 17 patients) were included. The mean age at surgery was 26.74 months (range: 2-72 months). The mean postoperative follow-up was 27.8 months (range: 6-72 months). Primary IOL implantation was performed in 25 eyes, 21 of which had the IOL implanted in the capsular bag. Fifty eyes had a central round pupil. The median logarithm of the minimum angle of resolution visual acuity was 0.3 in patients with unilateral cataract and 0.1 in those with bilateral cataract. Three eyes (5.9%) developed visual axis opacification (VAO) and required further surgery. Univariate analysis using Fisher's exact test indicated that surgery in the first 12 months of life was significantly associated with development of VAO (p=0.047). The incidence of postoperative VAO was approximately 15.8% in this age group.
Triamcinolone-assisted vitrectomy can be used in pediatric cataract surgery without serious long-term adverse effects. While the incidence of VAO is low, it appears unavoidable in approximately one-sixth of patients who undergo surgery before 12 months of age.
背景/目的：评估行晶状体切除术、后囊切开术和曲安奈德辅助玻璃体切除术治疗先天性白内障的儿科患者的结局。
本回顾性研究纳入了 2006 年 7 月至 2012 年 12 月期间在国立台湾大学医院因白内障而行晶状体切除术、后囊切开术和曲安奈德辅助玻璃体切除术且行或不行人工晶状体（IOL）植入术的 34 例年龄小于 72 个月的患者。
34 例患者（单侧 17 例，双侧 17 例）的 51 只眼纳入研究。手术时的平均年龄为 26.74 个月（范围：2-72 个月）。平均术后随访时间为 27.8 个月（范围：6-72 个月）。25 只眼行一期 IOL 植入术，其中 21 只眼将 IOL 植入囊袋内。50 只眼瞳孔呈中央圆形。单侧白内障患者的最小分辨角视力对数均值为 0.3，双侧白内障患者的最小分辨角视力对数均值为 0.1。3 只眼（5.9%）发生视觉轴混浊（VAO），需要进一步手术。Fisher 确切概率法的单变量分析表明，在生命的头 12 个月内进行手术与 VAO 的发生显著相关（p=0.047）。在该年龄组，术后 VAO 的发生率约为 15.8%。
曲安奈德辅助玻璃体切除术可用于儿科白内障手术，无严重的长期不良影响。尽管 VAO 的发生率较低，但在约六分之一于 12 个月龄前接受手术的患者中，VAO 似乎不可避免。
