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30 个月以下儿童二期人工晶状体植入的长期效果。

Long-term results of secondary intraocular lens implantation in children under 30 months of age.

机构信息

University of São Paulo (USP), São Paulo, Brazil.

Sant Joan de Déu Hospital, Barcelona, Spain.

出版信息

Eye (Lond). 2018 Dec;32(12):1858-1863. doi: 10.1038/s41433-018-0191-3. Epub 2018 Aug 28.

Abstract

PURPOSE

To report the long-term outcome of early secondary intraocular lens (IOL) implantation following congenital cataract extraction in a large number of eyes.

METHODS

Data of aphakic children under 30 months of age who underwent secondary IOL implantation and had at least one year of follow-up after the surgery was reviewed. In all of the patients, a foldable three-piece acrylic IOL was implanted in the ciliary sulcus by the same surgeon using the same technique. The database studied included refractive and visual acuity (VA) outcomes and complications.

RESULTS

Fifty patients (75 eyes) were included. The average age at the time of cataract extraction was 94.20 ± 44.94 days and 20.7 ± 6.0 months in the secondary IOL implantation. After 82.32 ± 48.91 months, the VA was 0.58 ± 0.35 LogMAR and the spherical equivalent was -2.20 ± 4.19 D. There was a negative correlation between a longer follow-up period and myopia at the SE measured (P = .001). The most frequent complications included glaucoma and corectopia. Performing the secondary IOL implantation ≤ 20 months of age was not a risk factor for glaucoma development (P = 0.095).

CONCLUSION

Secondary IOL implantation under 30 months of age is an option for children with unsatisfactory management of the optic treatment. A predictable IOL power calculation and satisfactory visual outcomes compared to results of later secondary IOL implantation are possible.

摘要

目的

报告大量先天性白内障摘除术后早期行二期人工晶状体(IOL)植入的长期结果。

方法

回顾了年龄在 30 个月以下的无晶状体儿童的数据,这些儿童接受了二期 IOL 植入术,并且在手术后至少有一年的随访。所有患者均由同一位外科医生采用相同技术在睫状沟内植入折叠式三片式丙烯酸 IOL。研究的数据库包括屈光和视力(VA)结果和并发症。

结果

共纳入 50 例(75 只眼)患者。白内障摘除时的平均年龄为 94.20 ± 44.94 天,二期 IOL 植入时为 20.7 ± 6.0 个月。82.32 ± 48.91 个月后,VA 为 0.58 ± 0.35 LogMAR,等效球镜为-2.20 ± 4.19 D。随访时间越长,等效球镜度数越偏近视,两者呈负相关(P=0.001)。最常见的并发症包括青光眼和核异位。二期 IOL 植入≤20 个月并不是青光眼发生的危险因素(P=0.095)。

结论

30 个月以下儿童行二期 IOL 植入术是光学治疗不满意儿童的一种选择。与后期二期 IOL 植入术相比,可进行可预测的 IOL 屈光度计算,并获得满意的视力结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4274/6292907/786278092db0/41433_2018_191_Fig1_HTML.jpg

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