Bothun Erick D, Wilson M Edward, Yen Kimberly G, Anderson Jill S, Weil Natalie C, Loh Allison R, Morrison David, Freedman Sharon F, Plager David A, Vanderveen Deborah K, Traboulsi Elias I, Hodge David O, Lambert Scott R
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota; Department of Ophthalmology and Visual Neurosciences, Minneapolis, University of Minnesota, Minnesota.
Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina.
Ophthalmology. 2021 Feb;128(2):302-308. doi: 10.1016/j.ophtha.2020.07.020. Epub 2020 Jul 15.
To evaluate outcomes of bilateral cataract surgery in children aged 7 to 24 months and compare rates of adverse events (AEs) with other Toddler Aphakia and Pseudophakia Study (TAPS) registry outcomes.
Retrospective clinical study at 10 Infant Aphakia Treatment Study (IATS) sites. Statistical analyses comparing this cohort with previously reported TAPS registry cohorts.
Children enrolled in the TAPS registry between 2004 and 2010.
Children underwent bilateral cataract surgery with or without intraocular lens (IOL) placement at age 7 to 24 months with 5 years of postsurgical follow-up.
Visual acuity (VA), occurrence of strabismus, AEs, and reoperations.
A total of 40 children (76 eyes) who underwent bilateral cataract surgery with primary posterior capsulectomy were identified with a median age at cataract surgery of 11 months (7-23); 68% received a primary IOL. Recurrent visual axis opacification (VAO) occurred in 7.5% and was associated only with the use of an IOL (odds ratio, 6.10; P = 0.005). Glaucoma suspect (GS) was diagnosed in 2.5%, but no child developed glaucoma. In this bilateral cohort, AEs (8/40, 20%), including glaucoma or GS and VAO, and reoperations occurred in a similar proportion to that of the published unilateral TAPS cohort. When analyzed with children aged 1 to 7 months at bilateral surgery, the incidence of AEs and glaucoma or GS correlated strongly with age at surgery (P = 0.011/0.004) and glaucoma correlated with microcornea (P = 0.040) but not with IOL insertion (P = 0.15).
Follow-up to age 5 years after bilateral cataract surgery in children aged 7 to 24 months reveals a low rate of VAO and very rare glaucoma or GS diagnosis compared with infants with cataracts operated at < 7 months of age despite primary IOL implantation in most children in the group aged 7 to 24 months. The use of an IOL increases the risk of VAO irrespective of age at surgery.
评估7至24个月大儿童双侧白内障手术的效果，并将不良事件（AE）发生率与其他幼儿无晶状体和假晶状体研究（TAPS）登记结果进行比较。
在10个婴儿无晶状体治疗研究（IATS）地点进行的回顾性临床研究。将该队列与先前报告的TAPS登记队列进行统计分析比较。
2004年至2010年期间纳入TAPS登记的儿童。
儿童在7至24个月大时接受双侧白内障手术，有或无人工晶状体（IOL）植入，并进行5年术后随访。
视力（VA）、斜视发生率、不良事件和再次手术情况。
共确定40名接受双侧白内障手术并一期后囊切开术的儿童（76只眼），白内障手术时的中位年龄为11个月（7 - 23个月）；68%接受了一期人工晶状体植入。复发性视轴混浊（VAO）发生率为7.5%，且仅与人工晶状体的使用有关（优势比，6.10；P = 0.005）。青光眼疑似病例（GS）诊断率为2.5%，但无儿童发展为青光眼。在这个双侧队列中，不良事件（8/40，20%），包括青光眼或GS以及VAO，和再次手术的发生率与已发表的单侧TAPS队列相似。当与双侧手术时年龄为1至7个月的儿童进行分析时，不良事件和青光眼或GS的发生率与手术时年龄密切相关（P = 0.011/0.004），青光眼与小角膜相关（P = 0.040），但与人工晶状体植入无关（P = 0.15）。
对7至24个月大儿童双侧白内障手术后至5岁的随访显示，与7个月以下接受白内障手术婴幼儿相比，VAO发生率较低，青光眼或GS诊断非常罕见，尽管该组7至24个月大的大多数儿童接受了一期人工晶状体植入。人工晶状体的使用增加了VAO的风险，与手术时年龄无关。
