Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Eur J Ophthalmol. 2021 Nov;31(6):3379-3385. doi: 10.1177/1120672120965493. Epub 2020 Oct 18.
To analyse the outcomes of sutureless and sutured scleral fixated intraocular lenses (SFIOL) in paediatric population.
Vitreoretina department of a tertiary eye care institute in Southern India.
Retrospective case series.
Data were collected from January 2010 to December 2018 for children less than 18 years of age, based on the following parameters: demographics, pre-operative characteristics, duration between aphakia and surgery, previous amblyopia treatment, the uncorrected (UCVA) and the best corrected visual acuity (BCVA) at baseline and, 1,6 and 12 months or final visit. Early and late post-operative complications along with details of any resurgery was recorded.
The study included 45 eyes of 43 patients. The mean age when children became aphakic was 8.8±3.6 years and the mean age at SFIOL implantation 10.1 ± 3.9 years. Sutureless SFIOL was performed for 36 (80%) eyes. The improvement in UCVA was statistically significant at 1-month follow up. Transient hypotony (n = 3), vitreous hemorrhage ( = 7) and raised IOP ( = 4) were the most observed early post-operative complications, while haptic exposure or disinsertion ( = 4, 9%) was a delayed postoperative complication. The mean spherical equivalent at the last follow up was 1.96 ± 0.83D and mean postoperative cylinder 2.32 ± 1.3D. The children were followed up for a mean duration of 20 ± 21.7 months. History of previous vitrectomy was found to be associated with two line reduction in UCVA (95% CI = 0.03-0.5 logMAR, = 0.008).
SFIOLs- sutured and sutureless; both were suitable for the rehabilitation of paediatric aphakia. Sutureless scleral fixation is a safe alternative for children but prospective studies with longer follow-up are needed.
分析儿童无缝线和缝线巩膜固定型人工晶状体（SFIOL）的治疗效果。
印度南部一家三级眼科保健机构的玻璃体视网膜科。
回顾性病例系列。
本研究纳入了 2010 年 1 月至 2018 年 12 月期间年龄小于 18 岁的儿童患者，收集了以下参数的数据：人口统计学资料、术前特征、白内障摘除与手术之间的时间间隔、既往弱视治疗、基础期、1 个月、6 个月和 12 个月或最后随访时的未矫正视力（UCVA）和最佳矫正视力（BCVA）。记录了早期和晚期术后并发症以及任何再次手术的详细信息。
本研究共纳入 43 例患者的 45 只眼。儿童发生无晶状体的平均年龄为 8.8±3.6 岁，SFIOL 植入的平均年龄为 10.1±3.9 岁。36 只（80%）眼行无缝线 SFIOL 术。1 个月随访时，UCVA 改善具有统计学意义。最常见的早期术后并发症包括短暂低眼压（n=3）、玻璃体积血（n=7）和眼压升高（n=4），而迟发性术后并发症包括巩膜扣带线暴露或松解（n=4，9%）。最后一次随访时的平均球镜等效值为 1.96±0.83D，平均术后柱镜值为 2.32±1.3D。儿童平均随访时间为 20±21.7 个月。研究发现，既往玻璃体切割术与 UCVA 降低两行（95%CI=0.03-0.5 logMAR， = 0.008）相关。
缝线和无缝线 SFIOL 均适用于儿童无晶状体眼的康复。无缝线巩膜固定是儿童的安全替代选择，但需要进行前瞻性、随访时间更长的研究。
