Department of Ophthalmology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea; Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.
Department of Ophthalmology, Jeju National University College of Medicine, Jeju City, South Korea.
Am J Ophthalmol. 2019 Dec;208:265-272. doi: 10.1016/j.ajo.2019.08.005. Epub 2019 Aug 23.
To evaluate the long-term incidence and risk of glaucoma after bilateral congenital cataract surgery in microphthalmic eyes.
Retrospective, observational case series.
Subjects: Children with microphthalmic eyes who had undergone surgery for bilateral congenital cataract within 6 months of birth and been followed up for at least 5 years.
Review of medical records at our institution.
Probability of an eye's developing glaucoma after bilateral congenital cataract surgery and associated risk factors.
Thirty-eight eyes of 19 children with bilateral congenital cataract were included. The mean age at surgery was 3.2 ± 1.7 months, and the mean follow-up duration was 7.79 ± 2.61 years. After cataract surgery, 11 eyes (29.0%) developed glaucoma at the age of 4.0 ± 1.4 years. Three of these eyes underwent Ahmed glaucoma valve implantation surgery. The probability of an eye's developing glaucoma was estimated to be 32.0% by 10 years after surgery. In a multivariate analysis, axial length was significantly associated with glaucoma development (odds ratio = 0.364, P = .025). Age at the time of cataract surgery, corneal diameter, and aphakia did not affect the risk of glaucoma (P > .10). Eyes without glaucoma had a better final visual outcome than those with glaucoma (0.75 ± 0.60 and 1.47 ± 1.10 logMAR, respectively, P = .049).
The long-term cumulative risk of postoperative glaucoma development was 32.0% by 10 years after bilateral congenital cataract surgery. Because the risk of developing glaucoma persists for several years after surgery, careful monitoring and control of intraocular pressure is needed to preserve vision in such patients.
评估小眼先天性白内障术后双眼发生青光眼的长期发病率和风险。
回顾性、观察性病例系列研究。
研究对象：出生后 6 个月内接受双侧先天性白内障手术且随访至少 5 年的小眼患者。
回顾性分析我院病历资料。
双眼白内障手术后发生青光眼的概率及其相关危险因素。
纳入 19 例双侧先天性白内障患儿的 38 只眼。手术时的平均年龄为 3.2 ± 1.7 个月，平均随访时间为 7.79 ± 2.61 年。白内障手术后，11 只眼（29.0%）在 4.0 ± 1.4 岁时发生青光眼。其中 3 只眼接受了 Ahmed 青光眼阀植入术。术后 10 年，预计 1 只眼发生青光眼的概率为 32.0%。多变量分析显示，眼轴长度与青光眼的发生显著相关（比值比=0.364，P=0.025）。手术时的年龄、角膜直径和无晶状体对青光眼的发病风险无影响（P＞0.10）。无青光眼的眼最终视力优于青光眼眼（分别为 0.75 ± 0.60 和 1.47 ± 1.10 logMAR，P=0.049）。
双侧先天性白内障术后 10 年时，青光眼的长期累积发病风险为 32.0%。由于术后数年仍有发生青光眼的风险，因此需要对这些患者进行仔细监测和眼压控制，以保护视力。
