Unit of Lens, Refractive and Pediatric Cataract, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Unit of Pediatric Ophthalmology, ASG Eye Hospital, Arera Colony, Bhopal, Madhya Pradesh, India.
Indian J Ophthalmol. 2019 Jul;67(7):1068-1072. doi: 10.4103/ijo.IJO_1327_18.
To prospectively evaluate the biometric changes in Indian pediatric cataract and postoperative refractive status.
A total of 147 patients were recruited into three groups: age <6 months, age between 7 months and 18 months, and age between 19 and 60 months and prospectively observed for 6 months. Exclusion criteria were preterm birth, microphthalmia, microcornea, megalocornea, uveitis, glaucoma, and traumatic or complicated cataract. Axial length and keratometry, the primary outcome measures, were taken preoperatively under general anesthesia before surgery. These children were followed up for 6 months to look for refractive and biometric changes. T-test and linear regression with the logarithm of independent variables were done.
All unilateral cataractous eyes (n = 25) and randomly selected bilateral cases (n = 122) were included in the analysis, for a total of 147 eyes. Mean age was 17.163 ± 13.024 months; axial length growth was 0.21, 0.18, 0.06 mm/month, and keratometry decline was 0.083, 0.035, 0.001 D/month in age groups 0-6, 7-18, and 19-60 months, respectively. The visual acuity improved in log MAR from 1.020 to 0.745 at 6 months postoperatively. There was statistically significant (Spearman's correlation coefficient = -0.575, P < 0.001) between age and postoperative refraction. There were no intraocular lens (IOL)-related complications seen in the immediate postoperative period. Peripheral opacification was seen in 102 eyes and central opacification in 1 eye at a 6-month follow-up.
Indian eyes have a lower rate of axial length growth and keratometry change in comparison with western eyes implying smaller undercorrection in emmetropic IOL power for Indian pediatric eyes to achieve a moderate amount of hyperopia.
前瞻性评估印度小儿白内障的生物测量变化和术后屈光状态。
共招募了 147 名患者,分为三组:<6 个月龄组、7-18 个月龄组和 19-60 个月龄组,并进行了 6 个月的前瞻性观察。排除标准为早产儿、小眼球、小角膜、大角膜、葡萄膜炎、青光眼和外伤性或复杂性白内障。全身麻醉下术前测量眼轴长度和角膜曲率,作为主要观察指标。这些儿童在术后 6 个月内随访,观察屈光和生物测量变化。采用 T 检验和对数自变量的线性回归进行分析。
共纳入 25 只单侧白内障眼(n=25)和随机选择的双侧病例(n=122),共 147 只眼。平均年龄为 17.163±13.024 个月;0-6、7-18 和 19-60 个月组的眼轴增长分别为 0.21、0.18、0.06mm/月,角膜曲率下降分别为 0.083、0.035、0.001D/月。术后 6 个月视力从 logMAR 1.020 提高到 0.745。年龄与术后屈光度之间存在显著的统计学相关性(Spearman 相关系数=-0.575,P<0.001)。术后即刻未发现人工晶状体(IOL)相关并发症。6 个月随访时,102 只眼出现周边混浊,1 只眼出现中央混浊。
与西方眼睛相比,印度眼睛的眼轴长度增长和角膜曲率变化率较低,这意味着在为印度小儿眼植入 IOL 时,为了实现适度的远视,需要更小的过矫量。