Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.
Am J Ophthalmol. 2019 Jan;197:121-127. doi: 10.1016/j.ajo.2018.09.022. Epub 2018 Sep 27.
To evaluate the long-term outcome of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy after cataract surgery in children.
Retrospective case series.
Electronic medical records of pediatric patients who underwent Nd:YAG laser posterior capsulotomy between January 1, 2008, and October 31, 2012, and followed up for more than 5 years were reviewed.
Thirty-one eyes of 25 patients were included. Only compliant patients assessed during slit-lamp examination and anterior segment photography underwent laser treatment. The mean age at the time of initial laser treatment was 9.04 ± 3.51 years (minimum 56 months), and the mean interval between cataract surgery and initial laser treatment was 28.1 ± 22.1 months. Posterior capsular openings were successfully made in 26 (83.9%) eyes with a single attempt and in 3 (9.7%) eyes with a second attempt. Overall success rate was 93.5%. The logMAR best-corrected visual acuity was significantly improved from 0.61 ± 0.36 to 0.19 ± 0.25 at 1 month posttreatment (P < .0001) and well maintained, at least for 5 years of follow-up, without serious complications. The recurrence of posterior capsular opacity was observed in 7 (24.1%) eyes, which was successfully managed by repeated laser procedure or surgical capsulectomy.
By selecting compliant patients and repeated attempts, Nd:YAG laser posterior capsulotomy can be successfully performed in a pediatric population without serious complications. Laser treatment is also a good option for managing recurred posterior capsular opacity. Restored visual acuity can be maintained for at least 5 years.
评估儿童白内障术后钕：钇铝石榴石（Nd：YAG）激光后囊切开术的长期疗效。
回顾性病例系列。
回顾了 2008 年 1 月 1 日至 2012 年 10 月 31 日期间接受 Nd：YAG 激光后囊切开术且随访时间超过 5 年的小儿患者的电子病历。
25 例患者的 31 只眼纳入研究。仅对裂隙灯检查和眼前段摄影评估符合条件的患者进行激光治疗。初次激光治疗时的平均年龄为 9.04 ± 3.51 岁（最小 56 个月），白内障手术后至初次激光治疗的平均间隔时间为 28.1 ± 22.1 个月。26 只眼（83.9%）单次尝试成功打开后囊，3 只眼（9.7%）需 2 次尝试。总体成功率为 93.5%。术后 1 个月最佳矫正视力从 logMAR 0.61 ± 0.36 提高到 0.19 ± 0.25（P <.0001），至少在 5 年的随访中保持良好，无严重并发症。7 只眼（24.1%）后囊混浊复发，通过重复激光或手术囊切除术成功治疗。
通过选择符合条件的患者并重复尝试，Nd：YAG 激光后囊切开术可在儿童人群中安全实施，且无严重并发症。激光治疗也是治疗后发性后囊混浊的一种良好选择。视力恢复可至少维持 5 年。
