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小儿眼球巩膜缝线固定型人工晶状体的手术效果和并发症。

Surgical outcomes and complications of sutured scleral fixated intraocular lenses in pediatric eyes.

机构信息

Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India..

Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India.

出版信息

Can J Ophthalmol. 2018 Feb;53(1):49-55. doi: 10.1016/j.jcjo.2017.07.015. Epub 2017 Sep 27.

Abstract

OBJECTIVE

To study the outcome and complications of sutured scleral fixated intraocular lenses (SSFIOL) in children.

DESIGN

Retrospective study.

SUBJECTS

A total of 279 eyes of 230 children who underwent SSFIOL at ≤18 years of age in a tertiary eye care centre in India.

METHODS

Treatment-naive children having traumatic cataract or subluxated lens underwent a single-sitting lensectomy and pars plana vitrectomy (PPV), along with SSFIOL insertion. Children with aphakia underwent PPV with SSFIOL, and vitrectomized eyes underwent only SSFIOL implantation. Fixation of SSFIOL was done by the 4-point ab externo fixation technique using 10-0 prolene suture.

MAIN OUTCOME MEASURES

Preoperative and postoperative visual acuity, as well as intraoperative and postoperative complications.

RESULTS

The mean age at which SSFIOL was performed was 10.8 ± 4.22 years. The most common indication of SSFIOL in our study was traumatic subluxation of lens (47.63%; n = 133 patients), followed by congenital subluxation in 38.7% (n = 108). Best-corrected visual acuity was maintained or improved from the preoperative visual acuity in 93.19% of eyes. The complications included choroidal detachment in 2.86% (n = 8), dispersed vitreous hemorrhage in 2.86% (n = 8), endophthalmitis in 0.72% (n = 2), raised intraocular pressure in 12.54% (n = 35), diplopia in 0.72% (n = 2), retinal detachment in 5.73% (n = 16), and dislocation of the SSFIOL in 4.6% (n = 13). The mean follow-up after SSFIOL implantation was 39.68 months.

CONCLUSIONS

SSFIOLs are effective in correcting aphakia in children; long-term follow-up of these children is, however, necessary.

摘要

目的

研究儿童巩膜缝线固定型人工晶状体(SSFIOL)的结果和并发症。

设计

回顾性研究。

受试者

在印度一家三级眼科中心,共有 230 名儿童的 279 只眼,年龄均≤18 岁,接受了 SSFIOL 治疗。

方法

未经治疗的儿童患有外伤性白内障或晶状体半脱位,行单次晶状体切除术联合巩膜层间平坦部玻璃体切除术(PPV),同时行 SSFIOL 植入术。无晶状体儿童行 PPV 联合 SSFIOL,玻璃体切除眼仅行 SSFIOL 植入术。采用 10-0 prolene 缝线的外固定四点固定技术固定 SSFIOL。

主要观察指标

术前和术后视力以及术中、术后并发症。

结果

SSFIOL 手术的平均年龄为 10.8 ± 4.22 岁。本研究中 SSFIOL 最常见的适应证是外伤性晶状体半脱位(47.63%;n = 133 例患者),其次是先天性晶状体半脱位(38.7%;n = 108 例)。93.19%的眼术后最佳矫正视力保持或优于术前视力。并发症包括脉络膜脱离 2.86%(n = 8)、弥漫性玻璃体出血 2.86%(n = 8)、眼内炎 0.72%(n = 2)、高眼压 12.54%(n = 35)、复视 0.72%(n = 2)、视网膜脱离 5.73%(n = 16)和 SSFIOL 脱位 4.6%(n = 13)。SSFIOL 植入术后平均随访 39.68 个月。

结论

SSFIOL 可有效矫正儿童无晶状体眼;然而,这些儿童需要长期随访。

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