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先天性心脏病手术后儿童的眼压:一项单中心研究。

Intraocular pressure in children after congenital heart surgery: A single-center study.

作者信息

Goyal Sunali, Phillips Paul H, Corder Lamonda A, Robertson Michael J, Garcia Xiomara, Schmitz Michael L, Gupta Punkaj

机构信息

Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Department of Pediatric Ophthalmology, Arkansas Children's Hospital, Little Rock, Arkansas, USA.

出版信息

Ann Pediatr Cardiol. 2017 Sep-Dec;10(3):234-239. doi: 10.4103/apc.APC_41_17.

Abstract

BACKGROUND

The impact of varied cardiac physiologies on intraocular pressure (IOP) among children undergoing heart operations is unknown.

AIM

The aim of this study was to determine the IOP among children with varying cardiovascular physiologies and varying hemodynamics after their heart operation.

SETTING AND DESIGN

This was a prospective, observational study.

MATERIALS AND METHODS

Patients ≤18 years undergoing congenital heart surgery were included in this study. IOP measurement was performed by Icare® tonometer between 3 and 14 days after heart operation.

STATISTICAL ANALYSIS

Summary statistics were estimated for all demographic, anthropometric, and clinical data.

RESULTS

A total of 116 eyes from 58 children were included. The mean and standard deviation age was 28.4 (45.8) months. Single-ventricle anatomy was present in 26 patients (45%). Despite similar heart rate and blood pressure, the mean IOP among the patients with single-ventricle anatomy was significantly elevated as compared to patients with two-ventricle anatomy (18 mm Hg vs. 12 mm Hg, < 0.001). There was no difference in IOP measurements based on the complexity of operation performed. We noted that patients undergoing surgical palliation with central shunt (21 mm Hg), Fontan operation (19 mm Hg), bidirectional Glenn operation (19 mm Hg), Norwood operation (19 mm Hg), or definitive repairs such as tetralogy of Fallot repair (17 mm Hg), and atrioventricular canal repair (19 mm Hg) were associated with the highest IOPs in the study cohort.

CONCLUSIONS

This study demonstrates that IOPs vary with varying cardiovascular physiology after pediatric cardiac surgery.

摘要

背景

心脏手术患儿中不同心脏生理状态对眼压(IOP)的影响尚不清楚。

目的

本研究旨在确定心脏手术后具有不同心血管生理状态和不同血流动力学的患儿的眼压。

设置与设计

这是一项前瞻性观察性研究。

材料与方法

本研究纳入了年龄≤18岁接受先天性心脏手术的患者。在心脏手术后3至14天使用Icare®眼压计进行眼压测量。

统计分析

对所有人口统计学、人体测量学和临床数据进行汇总统计。

结果

共纳入了58名儿童的116只眼睛。平均年龄和标准差为28.4(45.8)个月。26例患者(45%)存在单心室解剖结构。尽管心率和血压相似,但与双心室解剖结构的患者相比,单心室解剖结构患者的平均眼压显著升高(18 mmHg对12 mmHg,<0.001)。根据所进行手术的复杂性,眼压测量没有差异。我们注意到,在本研究队列中,接受中心分流手术姑息治疗(21 mmHg)、Fontan手术(19 mmHg)、双向Glenn手术(19 mmHg)、Norwood手术(19 mmHg)或确定性修复如法洛四联症修复(17 mmHg)和房室管修复(19 mmHg)的患者眼压最高。

结论

本研究表明,小儿心脏手术后眼压随心血管生理状态的不同而变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98d9/5594933/9454f66304fd/APC-10-234-g004.jpg

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