Baris Mine, Biler Elif Demirkilinc, Yilmaz Suzan Guven, Ates Halil, Uretmen Onder, Kose Suheyla
Department of Ophthalmology, Faculty of Medicine, Ege University, 35040, Bornova, Izmir, Turkey.
Int Ophthalmol. 2019 Jan;39(1):11-19. doi: 10.1007/s10792-017-0777-y. Epub 2017 Nov 30.
To evaluate the clinical findings and possible risk factors of patients with aphakic glaucoma following congenital cataract surgery and identify the factors affecting response to glaucoma treatment.
A retrospective chart review of 173 patients was performed who underwent congenital cataract surgery before the age of 12 months and 40 eyes of 25 patients with aphakic glaucoma were enrolled. Age of the patients at the time of the cataract surgery, postoperative complications, additional ocular pathologies and the type of glaucoma treatment needed were investigated.
Mean age of 25 patients at the time of cataract surgery was 3.31 ± 2.28 (range 1-11) months with a mean follow-up period of 79 ± 30.5 (32-176) months. Out of 40 eyes, medical therapy was effective in 20 (50%) eyes, whereas 20 (50%) eyes needed surgery for glaucoma. In these 20 eyes, 6 (30%) eyes underwent only 1, 4 (20%) eyes underwent 2 and 10 (50%) eyes underwent 3 or more procedures. Age at the time of cataract surgery, pupillary membrane formation and additional ocular pathologies were not significantly associated both with the need for glaucoma surgery or the number of operations (p ≥ 0.05).
Aphakic glaucoma following congenital cataract surgery is a serious complication which requires surgery in half (50%) of the patients. Usually, more than one surgical procedure (70%) is needed. It can be detected even years after cataract surgery (range 0.3-94 months), so long-term careful follow-up is necessary.
评估先天性白内障手术后无晶状体性青光眼患者的临床特征及可能的危险因素，并确定影响青光眼治疗反应的因素。
对173例12个月龄前接受先天性白内障手术的患者进行回顾性病历审查，纳入25例无晶状体性青光眼患者的40只眼。调查患者白内障手术时的年龄、术后并发症、其他眼部病变以及所需的青光眼治疗类型。
25例患者白内障手术时的平均年龄为3.31±2.28（范围1 - 11）个月，平均随访期为79±30.5（32 - 176）个月。40只眼中，药物治疗对20只眼（50%）有效，而20只眼（50%）需要进行青光眼手术。在这20只眼中，6只眼（30%）仅接受了1次手术，4只眼（20%）接受了2次手术，10只眼（50%）接受了3次或更多次手术。白内障手术时的年龄、瞳孔膜形成及其他眼部病变与青光眼手术需求或手术次数均无显著相关性（p≥0.05）。
先天性白内障手术后的无晶状体性青光眼是一种严重并发症，半数（50%）患者需要手术治疗。通常需要不止一次手术（70%）。甚至在白内障手术后数年（范围为0.3 - 94个月）仍可发现，因此需要长期仔细随访。
