Chen Hui, Chen Wan, Wu Xiang-Hua, Lin Zhuo-Ling, Chen Jing-Jing, Li Xiao-Yan, Chen Wei-Rong, Lin Hao-Tian
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Center for Precision Medicine, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Int J Ophthalmol. 2021 Jan 18;14(1):64-71. doi: 10.18240/ijo.2021.01.09. eCollection 2021.
To compare the visual outcomes of children with small (≤3 mm) posterior polar cataracts (PPC) and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservatively.
Children who initially had small PPC and posterior lenticonus who were followed up over 1-year period were retrospective reviewed in the study. Patients receiving surgery were compared with those receiving conservative therapy. The axial length, keratometry, refraction, best-corrected visual acuity (BCVA), and strabismus measurements were recorded. Lens morphology, , the location, size, and depth of the cataract lesion, was measured with a Scheimpflug imaging system. To help control for baseline differences in the groups, patients were matched with controls by propensity score methodology.
The study evaluated 60 patients (30 in the surgery group and 30 in the conservative therapy group) after matching by propensity score. Patients who underwent cataract surgery showed greater BCVA improvements (0.36±0.24 logMAR) than patients who were treated without surgery (0.22±0.26 logMAR; =0.036). Surgery was effective in patients with a rear projection length (RPL) less than 1.0 mm and a pretreatment BCVA worse than 0.52 logMAR.
Children with small PPC and posterior lenticonus who undergo cataract surgery experience greater BCVA improvements than those managed conservatively. Certain patients presenting with a RPL less than 1.0 mm and a pretreatment BCVA of 0.52 logMAR or worse may benefit from surgery.
比较患有小（≤3毫米）后极性白内障（PPC）和后发性圆锥晶状体的儿童在接受白内障摘除手术后的视力结果与保守治疗的视力结果。
对最初患有小PPC和后发性圆锥晶状体且随访超过1年的儿童进行回顾性研究。将接受手术的患者与接受保守治疗的患者进行比较。记录眼轴长度、角膜曲率、验光、最佳矫正视力（BCVA）和斜视测量结果。使用Scheimpflug成像系统测量晶状体形态，即白内障病变的位置、大小和深度。为了控制组间的基线差异，采用倾向评分法将患者与对照组进行匹配。
通过倾向评分匹配后，该研究评估了60例患者（手术组30例，保守治疗组30例）。接受白内障手术的患者BCVA改善程度（0.36±0.24 logMAR）大于未接受手术治疗的患者（0.22±0.26 logMAR；P = 0.036）。手术对后投影长度（RPL）小于1.0毫米且术前BCVA低于0.52 logMAR的患者有效。
患有小PPC和后发性圆锥晶状体的儿童接受白内障手术后的BCVA改善程度大于保守治疗的儿童。某些RPL小于1.0毫米且术前BCVA为0.52 logMAR或更差的患者可能从手术中获益。
