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马凡综合征患儿的视力结果和手术效果。

Visual outcome and surgical results in children with Marfan syndrome.

机构信息

Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

出版信息

Clin Exp Ophthalmol. 2019 Dec;47(9):1138-1145. doi: 10.1111/ceo.13596. Epub 2019 Aug 2.

Abstract

IMPORTANCE

To determine visual and surgical results in children with Marfan syndrome.

BACKGROUND

Marfan syndrome involves ocular complications which can lead to visual disturbance and amblyopia. Data about the visual and surgical results in children with Marfan syndrome is vital for the clinical management of these patients.

DESIGN

Retrospective data analysis.

PARTICIPANTS

Eighty-two eyes of 41 patients with a genetically proved diagnosis of Marfan syndrome.

METHODS

Medical records of patients with Marfan syndrome were reviewed between 2007 and 2017. Ocular complications, visual acuity (VA) of patients with/without lensectomy and surgical method were evaluated.

MAIN OUTCOME MEASURES

VA outcomes of patients with Marfan syndrome with/without surgical repair of ectopia lentis.

RESULTS

In 27 (66%) of the 41 patients a bilateral subluxation of the lens was visible and 14 (52%) patients received lensectomy. The mean age at initial presentation was 12.3 ± 9 years and mean follow-up was 3 years (range 1-7). VA varied from 1.2 to -0.1 logMAR at first examination. At initial presentation, mean VA was 0.1 ± 0.7 logMAR in patients with a normal lens status (n = 14) and 0.3 ± 0.5 logMAR in patients with subluxation of the lens (n = 27) (P < .01). VA improved from 0.2 ± 0.5 logMAR to 0.1 ± 0.5 logMAR (P = .06) in children with subluxation of the lens who did not need a lensectomy (n = 12) and from 0.5 ± 0.5 logMAR to 0.2 ± 0.5 logMAR (P = .02) in patients who were referred to lensectomy with/without secondary lens implantation.

CONCLUSIONS AND RELEVANCE

In Marfan syndrome subluxation of the lens was found in the majority of children. Improvement of VA resulted in children with subluxation of the lens and following lensectomy.

摘要

重要性

确定马凡综合征患儿的视力和手术结果。

背景

马凡综合征涉及眼部并发症,可导致视力障碍和弱视。关于马凡综合征患儿的视力和手术结果的数据对于这些患者的临床管理至关重要。

设计

回顾性数据分析。

参与者

41 例马凡综合征患儿 82 只眼,均经基因诊断证实。

方法

回顾 2007 年至 2017 年间患有马凡综合征的患者的病历。评估患者的眼部并发症、有无晶状体切除术的患者视力(VA)和手术方法。

主要观察指标

马凡综合征患者行晶状体异位修复术前后的 VA 结果。

结果

41 例患者中 27 例(66%)双侧晶状体半脱位,14 例(52%)患者行晶状体切除术。初次就诊时的平均年龄为 12.3±9 岁,平均随访 3 年(1-7 年)。初次检查时 VA 从 1.2 到-0.1 logMAR 不等。初次就诊时,晶状体正常的患者平均 VA 为 0.1±0.7 logMAR(n=14),晶状体半脱位的患者为 0.3±0.5 logMAR(n=27)(P<.01)。12 例未行晶状体切除术的晶状体半脱位患儿的 VA 从 0.2±0.5 logMAR 提高至 0.1±0.5 logMAR(P=.06),行晶状体切除术联合/不联合二期晶状体植入术的患儿从 0.5±0.5 logMAR 提高至 0.2±0.5 logMAR(P=.02)。

结论和相关性

在马凡综合征中,晶状体半脱位在大多数儿童中发现。晶状体半脱位患儿 VA 改善,行晶状体切除术后 VA 进一步改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068e/6973035/b347171daa63/CEO-47-1138-g001.jpg

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