Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Eye (Lond). 2019 Sep;33(9):1411-1417. doi: 10.1038/s41433-019-0426-y. Epub 2019 Apr 3.
To assess the outcomes of intra-lenticular lens aspiration (ILLA) in paediatric cases with anterior dislocation of lens.
A retrospective review of medical records of cases with anterior dislocation of the lens in children (age < 16 years) that underwent ILLA between June 2017 and May 2018 was performed. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), and anterior segment findings were noted at presentation and follow-up. Surgical notes were reviewed for all cases. Post-operative central corneal thickness (CCT) and central macular thickness (CMT) were recorded.
Eleven eyes of eight patients with a median age of ten years underwent ILLA. There were four males and four females. The median duration of symptoms was 2 months, CDVA was 1.77 logMAR, and IOP was 16 mm of Hg. Ten eyes had corneo-lenticular touch with corneal oedema, and two had raised IOP at presentation. Homocystinuria (n = 2/8), Microspherophakia (n = 2/8), Marfan syndrome (n = 1/8), Buphthalmos (n = 1/8) and Ectopia lentis et pupillae (n = 1/8) were the identifiable causes for anterior dislocation. There were no intra-operative complications in any case. Immediate post-operative corneal oedema and raised IOP was observed in nine and three cases respectively and was treated with medical therapy. The median post-operative CDVA and IOP at 6-months was 1 logMAR and 15 mm of Hg respectively. The median CCT and CMT were 516 and 248 μm respectively. Five eyes developed a central corneal descemet scar.
ILLA is a safe and effective technique for surgical removal of an anteriorly dislocated lens in paediatric cases.
评估晶状体内抽吸术（ILLA）治疗儿童晶状体前脱位的效果。
对 2017 年 6 月至 2018 年 5 月期间接受 ILLA 治疗的儿童（年龄<16 岁）晶状体前脱位病例的病历进行回顾性分析。在就诊时和随访时记录矫正远距视力（CDVA）、眼内压（IOP）和眼前段情况。对所有病例的手术记录进行了回顾。记录术后中央角膜厚度（CCT）和中央黄斑厚度（CMT）。
8 例患者的 11 只眼接受了 ILLA，中位年龄为 10 岁，其中男性 4 例，女性 4 例。中位症状持续时间为 2 个月，CDVA 为 1.77 logMAR，IOP 为 16mmHg。10 只眼存在角膜-晶状体接触伴角膜水肿，2 只眼就诊时眼压升高。同型胱氨酸尿症（n=2/8）、小晶状体（n=2/8）、马凡综合征（n=1/8）、牛眼（n=1/8）和晶状体异位伴瞳孔（n=1/8）是晶状体前脱位的可识别原因。在任何情况下都没有发生术中并发症。术后即刻有 9 只眼出现角膜水肿，3 只眼眼压升高，均采用药物治疗。6 个月时的中位术后 CDVA 和 IOP 分别为 1 logMAR 和 15mmHg。中位 CCT 和 CMT 分别为 516μm 和 248μm。5 只眼出现中央角膜后弹力层瘢痕。
ILLA 是治疗儿童晶状体前脱位的一种安全有效的手术方法。
