Chen Wensi, He Shiping, Xiang Daoman
Department of Pediatric Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Tianhe District, Guangzhou 510230, Guangdong Province, China.
Aier Eye Hospital, No. 16 Zhongshan 5th Road, East District, Zhongshan 528400, Guangdong Province, China.
J Ophthalmol. 2020 Aug 6;2020:9489450. doi: 10.1155/2020/9489450. eCollection 2020.
The purpose of this study was to study the imaging features of ultrasound biomicroscopy (UBM) in the aphakia with visual axis opacification (VAO) after congenital cataract surgery.
From May 2015 to May 2018, aphakia patients with VAO who underwent congenital cataract surgery were examined by high-resolution bag/balloon UBM technique, and the results of UBM imaging were analyzed. According to UBM imaging features, different types of VAO were classified.
A total of 38 children (55 eyes) with VAO were included. 17 patients were bilateral, and 21 patients were unilateral. Patients with VAO were classified into 3 groups according to the UBM imaging features: membranous fibrosis VOA (17 cases, 28 eyes), cortical regeneration VOA (15 cases, 20 eyes), and mixed VOA (6 cases, 7 eyes). The patients in the membranous fibrosis group underwent Nd:YAG laser posterior capsulotomy, those in the cortical regeneration group underwent anterior vitrectomy, and those in the mixed type group underwent anterior vitrectomy with RF capsulotomy tip. After surgery, VAO were removed in all patients. During the follow-up period, in the membranous fibrotic VAO group, iris adhesion and pupillary occlusion were found in 2 eyes, and anterior vitrectomy combined with separation of iris adhesion was performed. In cortical regenerative and mixed type VAO groups, anterior vitrectomy was performed without opacity in the axial region. The total recurrence rate of VAO was 3.46%.
After congenital cataract surgery, the UBM imaging features of aphakia with VAO are helpful to evaluate the condition of VAO before reoperation so as to choose the optimal surgical method to achieve better therapeutic effect.
本研究旨在探讨先天性白内障手术后无晶状体眼合并视轴混浊（VAO）的超声生物显微镜（UBM）成像特征。
2015年5月至2018年5月，对接受先天性白内障手术的无晶状体眼合并VAO患者采用高分辨率囊袋/球囊UBM技术进行检查，并分析UBM成像结果。根据UBM成像特征对不同类型的VAO进行分类。
共纳入38例（55只眼）VAO患儿。17例为双侧，21例为单侧。根据UBM成像特征将VAO患者分为3组：膜性纤维化性VAO（17例，28只眼）、皮质再生性VAO（15例，20只眼）和混合型VAO（6例，7只眼）。膜性纤维化组患者行Nd:YAG激光后囊切开术，皮质再生组患者行前部玻璃体切除术，混合型组患者行前部玻璃体切除术联合射频囊切开刀。术后所有患者的VAO均被清除。随访期间，膜性纤维化性VAO组有2只眼出现虹膜粘连和瞳孔阻滞，行前部玻璃体切除术联合虹膜粘连分离术。皮质再生性和混合型VAO组在轴向区域无混浊而行前部玻璃体切除术。VAO的总复发率为3.46%。
先天性白内障手术后，无晶状体眼合并VAO的UBM成像特征有助于术前评估VAO情况，从而选择最佳手术方法以获得更好的治疗效果。
