Department of Ophthalmology, Justus-Liebig-University Giessen, University Hospital Giessen and Marburg GmbH, Giessen, Germany.
Acta Ophthalmol. 2020 Mar;98(2):e144-e154. doi: 10.1111/aos.14229. Epub 2019 Aug 17.
To report the rate and management of intra- and early postoperative complications of bag-in-the-lens intraocular lens (IOL) implantation technique for cataract treatment in paediatric patients of different age groups.
Department of Ophthalmology, Justus-Liebig-University Giessen, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany.
Retrospective non-randomized consecutive case series.
Ninety eyes of 60 paediatric cataract patients were enrolled to this retrospective non-randomized observational consecutive case series single-centre study. All patients underwent cataract surgery with bag-in-the-lens IOL implantation between January 2008 and December 2018, performed by two experienced surgeons. The entire cohort was divided into four age groups: first - 0-<3 months, second - 3-<12 months, third - 12-<36 and fourth - >36 months-17 years of age. The intra- and postoperative complications were based on the clinical records. The description of management of complications related specifically to bag-in-the-lens IOL technique was based on the 39 consecutive cases operated since 1 Jan 2016 by one single surgeon that were all video documented. The early postoperative period was defined as 12 months after surgery.
Overall, there were 27 unilateral and 33 bilateral surgical cases of 24 female and 36 male children. The mean age at surgery was 45.25 months (range 1-200 months). The most common intraoperative events were vitreous prolapse and anterior capsule rupture with 28.9% and 13.3%, respectively. Within 12 months of follow-up, five eyes (5.6%) were re-operated because of visual axis reo-pacification (VAR). Intraocular hypertension was diagnosed in seven eyes (7.8%), including two cases that required surgical treatment. In all cases with intra- and early postoperative complications related specifically to bag-in-the-lens technique, it was possible to manage them and successfully implant bag-in-the-lens IOL.
Implementation of bag-in-the-lens technique in the treatment of paediatric cataract was associated with a relatively low rate of intra- and postoperative complications, including rare cases of VAR. The correct management of complications related specifically to bag-in-the-lens IOL implantation technique shall to be considered during the learning curve.
报告不同年龄组儿童白内障患者行晶状体袋内人工晶状体（IOL）植入术治疗的术中及术后早期并发症发生率和处理方法。
德国吉森市 Justus-Liebig 大学吉森-马尔堡大学附属医院眼科。
回顾性非随机连续病例系列研究。
本回顾性非随机连续病例系列研究纳入了 2008 年 1 月至 2018 年 12 月间由两位经验丰富的外科医生施行晶状体袋内 IOL 植入术的 60 例（90 只眼）儿童白内障患者。所有患者均被分为四个年龄组：第一组，0-<3 个月；第二组，3-<12 个月；第三组，12-<36 个月；第四组，>36 个月-17 岁。并发症基于临床记录进行评估。与晶状体袋内 IOL 技术相关的并发症的处理方法基于自 2016 年 1 月 1 日以来由一位外科医生进行的 39 例连续手术（均进行了视频记录）。术后早期定义为术后 12 个月。
共有 27 例单侧和 33 例双侧手术，其中 24 例为女性，36 例为男性，患儿平均年龄为 45.25 个月（1-200 个月）。术中最常见的事件是玻璃体脱出和前囊破裂，发生率分别为 28.9%和 13.3%。术后 12 个月内，5 只眼（5.6%）因视力轴再混浊（VAR）而再次手术。诊断出 7 只眼（7.8%）眼内压升高，其中 2 例需要手术治疗。所有与晶状体袋内技术相关的术中及术后早期并发症，均可通过手术处理，并成功植入晶状体袋内 IOL。
在儿童白内障的治疗中应用晶状体袋内技术，其术中及术后并发症发生率相对较低，包括罕见的 VAR 病例。在学习曲线中，应考虑晶状体袋内 IOL 植入技术相关并发症的正确处理。
