From the School of Optometry and Ophthalmology, Wenzhou Medical University and the Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China.
From the School of Optometry and Ophthalmology, Wenzhou Medical University and the Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China.
J Cataract Refract Surg. 2018 Jul;44(7):871-877. doi: 10.1016/j.jcrs.2018.05.009.
To describe the diagnostic signs and biometric characteristics of preexisting posterior capsule defects in congenital cataract.
Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Retrospective case series.
Eyes with congenital cataract were reviewed and divided into a preexisting posterior capsule defect group (study group) and a control group with intact posterior capsules. Diagnostic signs were summarized on agreement of 3 ophthalmologists after they reviewed surgical videos. The biometric parameters, including central corneal thickness, anterior chamber depth, lens thickness, vitreous chamber depth, axial length, mean keratometry, corneal astigmatism, corneal diameter, and intraocular pressure, were compared between groups. The predictors of preexisting posterior capsule defect were determined using univariate and multivariate analyses.
The study comprised 81 eyes (53 patients). The diagnostic signs of preexisting posterior capsule defect included posterior capsule plaque with a well-demarcated margin, gray granules and vacuoles, and heterogeneous nuclear opacity (more dense in the posterior). The lens was significantly thinner in the study group than in the control group (P < .001). The corneal diameter was significantly smaller in the study group (P = .015 horizontal and P = .005 vertical). Multivariate analysis identified lens thickness as an independent predictor (odds ratio, 0.731; 95% confidence interval, 0.621-0.860; P < .001).
For preexisting posterior capsule defect, lens thickness was a valuable predictor and the presence of characteristic morphology was an important indicator. The cornea configuration suggests the need for further study of the role of genetic mutation.
描述先天性白内障中原有后囊膜缺损的诊断特征和生物测量特征。
中国浙江温州医科大学附属眼视光医院。
回顾性病例系列。
回顾性分析先天性白内障患者的病历资料，将患者分为存在原有后囊膜缺损组（研究组）和后囊膜完整组（对照组）。3 位眼科医生共同观看手术视频后，总结诊断特征。比较两组的生物测量参数，包括中央角膜厚度、前房深度、晶状体厚度、玻璃体腔深度、眼轴长度、平均角膜曲率、角膜散光、角膜直径和眼内压。采用单因素和多因素分析确定原有后囊膜缺损的预测因素。
本研究共纳入 81 只眼（53 例患者）。原有后囊膜缺损的诊断特征包括后囊膜斑块，边界清晰，有灰色颗粒和空泡，核混浊不均匀（后部密度较高）。与对照组相比，研究组的晶状体明显更薄（P<0.001）。研究组的角膜直径明显较小（P=0.015，水平；P=0.005，垂直）。多因素分析发现晶状体厚度是独立的预测因素（优势比，0.731；95%置信区间，0.621-0.860；P<0.001）。
对于原有后囊膜缺损，晶状体厚度是一个有价值的预测指标，而特征性形态的存在是一个重要的指标。角膜形态提示需要进一步研究遗传突变的作用。
