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先天性白内障手术后单眼无晶状体婴儿使用硬性透气性角膜接触镜和眼镜矫正的眼相关参数及不良事件评估:一项回顾性临床研究

Evaluation of eye-related parameters and adverse events of rigid gas permeable contact lens and spectacles correction in infants with monocular aphakia after congenital cataract surgery: a retrospective clinical study.

作者信息

Chen Junjue, Sun Ping, Wei Yan, Kang Xiaoli

机构信息

Department of Ophthalmology in XinHua hospital, Shanghai Jiao Tong University School of Medicine, No.1665 Kongjiang road , Yangpu District, Shanghai, China.

Department of Ophthalmology, Eye & Ent hospital, Fudan University, Fenyang road, Xuhui District, Shanghai, China.

出版信息

BMC Ophthalmol. 2019 Mar 20;19(1):81. doi: 10.1186/s12886-019-1088-z.

Abstract

BACKGROUND

Congenital cataract is currently one of the leading blindness-causing eye diseases in children. Surgical treatment only opens the visual pathway for children. The postoperative recovery of visual function is also dependent on effective optical correction and visual function training. In this study, we analyzed the changes in eye-related parameters, adverse events and the annual cost of rigid gas permeable contact lens (RGPCL) and spectacles correction in infants with monocular aphakia after congenital cataract surgery.

METHODS

To analyze the postoperative visual acuity, strabismus, nystagmus, myopic shift, globe axial length growth, adverse events, patient adherence to patching, and annual cost for patients with unilateral congenital cataract who underwent cataract surgery. Rigid gas permeable contact lenses or spectacles were used to correct aphakia after congenital cataract.

RESULTS

Of the 49 patients, 20 patients with unilateral aphakia who used RGPCL were in group 1. Group 2 comprised 14 patients with persistent fetal vasculature (PFV) who used RGPCL, and there were 15 patients with spectacles in group 3. In group 1, there were important improvements in visual acuity, strabismus and nystagmus. In groups 2 and 3, there were no significant improvements in visual acuity, strabismus or nystagmus. Patients with a good adherence to patching had better visual acuity after the operation than patients who did not, in groups 1 and 3. There were no significant differences in myopic shift or rate of globe axial length growth among the 3 groups. No patients in group 1 had ocular disease that affected visual acuity. The mean annual expenses of the RGPCL group was 3965 yuan, and the mean annual cost of spectacles was 1140 yuan to 2500 yuan.

CONCLUSION

RGPCL is a safe and effective optical correction method for patients with monocular aphakia after congenital cataract surgery. Spectacles are not an ideal optical correction. Using RGPCL to correct patients with PFV, the final visual acuity improved, but the difference was not statistically significant. There were no improvements in strabismus or nystagmus in patients with PFV.

摘要

背景

先天性白内障是目前导致儿童失明的主要眼病之一。手术治疗仅为儿童打开视觉通路。视功能的术后恢复还依赖于有效的光学矫正和视功能训练。在本研究中,我们分析了先天性白内障手术后单眼无晶状体婴儿使用硬性透气性角膜接触镜(RGPCL)和眼镜矫正的眼部相关参数变化、不良事件及年度费用。

方法

分析接受白内障手术的单侧先天性白内障患者的术后视力、斜视、眼球震颤、近视漂移、眼轴长度增长、不良事件、患者眼罩佩戴依从性及年度费用。先天性白内障后使用硬性透气性角膜接触镜或眼镜矫正无晶状体。

结果

49例患者中,20例使用RGPCL的单侧无晶状体患者为第1组。第2组包括14例使用RGPCL的永存原始玻璃体增生症(PFV)患者,第3组有15例使用眼镜的患者。第1组患者的视力、斜视和眼球震颤有显著改善。第2组和第3组患者的视力、斜视或眼球震颤无显著改善。在第1组和第3组中,眼罩佩戴依从性好的患者术后视力优于不依从的患者。3组之间的近视漂移或眼轴长度增长率无显著差异。第1组无影响视力的眼部疾病患者。RGPCL组的年均费用为3965元,眼镜的年均费用为1140元至2500元。

结论

RGPCL是先天性白内障手术后单眼无晶状体患者安全有效的光学矫正方法。眼镜不是理想的光学矫正方式。使用RGPCL矫正PFV患者,最终视力有所提高,但差异无统计学意义。PFV患者的斜视或眼球震颤无改善。

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本文引用的文献

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