Jin Sang Wook, Ryu Won Yeol
a Department of Ophthalmology, Dong-A University College of Medicine , Busan , Republic of Korea.
Semin Ophthalmol. 2019;34(6):451-457. doi: 10.1080/08820538.2019.1648689. Epub 2019 Jul 26.
: To determine the clinical manifestations and risk factors of developing strabismus in primary congenital glaucoma (PCG) patients who underwent glaucoma surgery. : A retrospective case-series study of 54 PCG patients who were followed for at least 3 years after glaucoma surgery. The subjects were divided into 2 groups based on the occurrence of strabismus. Age at glaucoma diagnosis and surgery, visual acuity, intraocular pressure, amblyopia, cup-disc ratio, and orthoptic status were compared between the 2 groups. : Twenty of 54 patients (37.0%) developed strabismus after glaucoma surgery. The mean ages at the time of glaucoma diagnosis and surgery were 3.2 ± 2.7 months and 3.4 ± 2.8 months in the strabismus group and 24.3 ± 19.1 months and 26.4 ± 18.9 months in the non-strabismus group, respectively ( < .05). In addition, the mean logMAR visual acuities were 0.87 ± 0.38 in the strabismus group and 0.24 ± 0.21 in the non-strabismus group ( < .05). The proportion of patients experiencing amblyopia was 90.0% in the strabismus group. Low visual acuity and young age at glaucoma surgery were significant predictors of developing strabismus. Kaplan-Meier survival analysis demonstrated that the probability of developing strabismus after glaucoma surgery was 50.6% at 10 years post-surgery. : PCG patients who developed strabismus after glaucoma surgery were diagnosed with glaucoma and underwent surgery at a younger age, exhibited a worse mean best corrected visual acuity, and exhibited a higher amblyopia incidence than did patients in the non-strabismus group.
确定接受青光眼手术的原发性先天性青光眼(PCG)患者发生斜视的临床表现和危险因素。
对54例PCG患者进行回顾性病例系列研究,这些患者在青光眼手术后至少随访3年。根据斜视的发生情况将受试者分为2组。比较两组患者青光眼诊断和手术时的年龄、视力、眼压、弱视、杯盘比和眼位情况。
54例患者中有20例(37.0%)在青光眼手术后发生斜视。斜视组青光眼诊断和手术时的平均年龄分别为3.2±2.7个月和3.4±2.8个月,非斜视组分别为24.3±19.1个月和26.4±18.9个月(P<0.05)。此外,斜视组的平均logMAR视力为0.87±0.38,非斜视组为0.24±0.21(P<0.05)。斜视组弱视患者的比例为90.0%。低视力和青光眼手术时年龄较小是发生斜视的重要预测因素。Kaplan-Meier生存分析表明,青光眼手术后10年发生斜视的概率为50.6%。
青光眼手术后发生斜视的PCG患者比非斜视组患者诊断青光眼和接受手术的年龄更小,平均最佳矫正视力更差,弱视发生率更高。