Valeina Sandra, Heede Santa, Erts Renars, Sepetiene Svetlana, Skaistkalne Elina, Radecka Liga, Vanags Juris, Laganovska Guna
Children's Clinical University Hospital, Riga, Latvia.
University Eye Clinic Eppendorf, Hamburg, Germany.
Eur J Ophthalmol. 2020 Sep;30(5):933-940. doi: 10.1177/1120672119845228. Epub 2019 Apr 26.
Intraocular lenses have always been a controversial topic in pediatric cataract surgery. In the early 1990s in the post-Soviet states of Eastern Europe, intraocular lenses promised an easier full-time correction and amblyopia treatment. Since 1991, ophthalmologists in Latvia have been implanting intraocular lenses in infants. Amount of the postoperative myopic shift and its influencing factors, analyzed in this article, are important indicators of congenital cataract treatment.
A retrospective chart review off 85 children (137 eyes) who underwent foldable posterior chamber intraocular lens implantation at the Clinical University Hospital in Riga, Latvia, from 1 January 2006 until 31 December 2016, was performed. Depending on the age at surgery, patients were divided into six groups: 1-6, 7-12, 13-24, 25-48, 49-84, and 85-216 months.
The largest and more variable myopic shift was found in a group of diffuse/total and nuclear cataract with surgery before the age of 6 months. There was a statistically significant correlation between the acquired best-corrected visual acuity and the amount of myopic shift (r = 0.33; p < 0.001). Comparing the amount of myopic shift in two groups of different intraocular lens implantation target refraction tactics, we did not find statistically significant differences. Comparing the amount of myopic shift and implanted intraocular lens power, a negative, statistically significant correlation was found.
The earlier the cataract extraction surgery and intraocular lens implantation is performed, the larger the myopic shift. The morphological type of cataract, best-corrected visual acuity, secondary glaucoma, and intraocular lens power influence the amount of myopic shift.
人工晶状体在儿童白内障手术中一直是个有争议的话题。20世纪90年代初，在东欧的后苏联国家，人工晶状体有望实现更简便的全时矫正和弱视治疗。自1991年以来，拉脱维亚的眼科医生一直在为婴儿植入人工晶状体。本文分析的术后近视漂移量及其影响因素是先天性白内障治疗的重要指标。
对2006年1月1日至2016年12月31日期间在拉脱维亚里加临床大学医院接受折叠式后房型人工晶状体植入术的85名儿童（137只眼）进行回顾性病历审查。根据手术时的年龄，患者被分为六组：1 - 6个月、7 - 12个月、13 - 24个月、25 - 48个月、49 - 84个月和85 - 216个月。
在6个月龄前接受手术的弥漫性/全白内障和核性白内障组中，发现近视漂移量最大且变化更大。获得的最佳矫正视力与近视漂移量之间存在统计学显著相关性（r = 0.33；p < 0.001）。比较两组不同人工晶状体植入目标屈光策略的近视漂移量，未发现统计学显著差异。比较近视漂移量与植入的人工晶状体度数，发现存在负的统计学显著相关性。
白内障摘除手术和人工晶状体植入越早进行，近视漂移越大。白内障的形态类型、最佳矫正视力、继发性青光眼和人工晶状体度数会影响近视漂移量。
