周边虹膜切除术预防儿童粘弹性人工晶状体手术中虹膜相关并发症。
Peripheral iridectomy for preventing iris-related complications in glued intraocular lens surgery in children.
机构信息
Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Department of Biostatistics, L V Prasad Eye Institute, Hyderabad, Telangana, India.
出版信息
Indian J Ophthalmol. 2020 Mar;68(3):466-470. doi: 10.4103/ijo.IJO_1120_19.
PURPOSE
To assess the role of surgical peripheral iridectomy (PI) in preventing iris-related complications associated with glued intraocular lens (GIOL) surgery in children with bilateral ectopia lentis.
METHODS
Nonrandomized interventional case series of 34 eyes of 17 children (<15 years of age) who underwent pars plana lensectomy (PPL) and GIOL surgery between January 2013 and December 2016. Eyes with surgical PI (January 2013-June 2015) were compared with those without surgical PI (July 2015-December 2016). The primary outcome measure of the role of surgical PI in GIOL surgery was to account for complications such as optic capture, secondary glaucoma, intraocular lens (IOL) dislocation, or repeat surgery. The secondary outcomes were changes in the best-corrected visual acuity (BCVA).
RESULTS
The mean age at surgery was 8.8 years (range: 3.5-15 years). Surgical PI was conducted in 15 eyes. Among the 19 eyes without PI, 9 eyes had complications (optic capture -6; rise in IOP -4; IOL subluxation -4; repeat surgery -5). The complications were significantly less in the PI group, P = 0.02. There was a statistically significant improvement in BCVA (P = 0.0001) in all the patients. The mean presenting BCVA was 0.99 (±0.79) logMAR (Snellen ≈ 20/200) and post BCVA was 0.40 (±0.50) (Snellen ≈ 20/50). The mean preoperative refraction was - 9 D (±8D) (range: -5 D to -23D) and postoperative was -1 (±1.15) D. The mean follow-up was 25.4 months.
CONCLUSION
Surgical PI along with GIOL surgery in children undergoing PPL is shown to reduce optic-capture-related complications.
目的
评估周边虹膜切除术（PI）在预防儿童双眼晶状体异位相关与粘弹剂固定人工晶状体（GIOL）手术相关虹膜并发症中的作用。
方法
回顾性非随机干预性病例系列研究，纳入 2013 年 1 月至 2016 年 12 月期间接受睫状体平坦部玻璃体切除术（PPL）和 GIOL 手术的 17 名儿童（年龄＜15 岁）的 34 只眼。将行周边虹膜切除术（PI）的眼（2013 年 1 月至 2015 年 6 月）与未行 PI 的眼（2015 年 7 月至 2016 年 12 月）进行比较。PI 手术在 GIOL 手术中的作用的主要结局测量指标是评估并发症，如光学捕获、继发性青光眼、人工晶状体（IOL）脱位或再次手术。次要结局是最佳矫正视力（BCVA）的变化。
结果
手术时的平均年龄为 8.8 岁（范围：3.5-15 岁）。15 只眼行周边虹膜切除术。在 19 只未行 PI 的眼中，9 只眼出现并发症（光学捕获-6 只眼；眼压升高-4 只眼；IOL 半脱位-4 只眼；再次手术-5 只眼）。PI 组的并发症明显较少，P = 0.02。所有患者的 BCVA 均有统计学显著改善（P = 0.0001）。平均初诊 BCVA 为 0.99（±0.79）logMAR（Snellen 视力≈20/200），术后为 0.40（±0.50）（Snellen 视力≈20/50）。术前平均屈光度为-9 D（±8D）（范围：-5 D 至-23D），术后为-1（±1.15）D。平均随访时间为 25.4 个月。
结论
在接受 PPL 的儿童中，PI 联合 GIOL 手术可降低与光学捕获相关的并发症。
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