Sadguru Netra Chikitsalaya, Jankikund, Chitrakoot, Madhya Pradesh, India.
Indian J Ophthalmol. 2021 Apr;69(4):937-945. doi: 10.4103/ijo.IJO_2276_20.
The aim of this study was to report the outcome of cataract surgery with different surgical techniques in eyes with coexisting coloboma and to define factors of prognostic importance.
Retrospective case sheet review of patients presenting between January 2016 and December 2018, who underwent cataract surgery in eyes with coexisting coloboma.
Of the 3,30,231 cases operated during the study period, 280 eyes of 276 patients had associated colobomatous malformation. The prevalence of coloboma in eyes undergoing cataract surgery was 0.085%. The mean age of the patients was 46.4 years (range 19 -88 years). Phacoemulsification (PE) was performed in 130 eyes (46.4%), manual small incision cataract surgery (M-SICS) was done in 115 eyes (41.1%), and 35 eyes (12.5%) underwent intra capsular cataract extraction. Intra-operative complications were noted in 26 (9%) eyes. Incidence of intra-operative and post-operative complications was comparable between PE and M-SICS groups (p = 0.94). The mean corrected distance visual acuity (CDVA) improved from logMAR 1.71 ± 0.62 to 0.87 ± 0.61 (p = 0.00009). On multivariate analysis, microcornea (p = 0.002), type 1 and 2 coloboma (p < 0.001), and intraoperative complications (p = 0.001) were associated with poor visual outcome.
Favorable functional outcomes can be achieved with phacoemulsification in eyes with softer cataract and corneal diameter >8 mm and with M-SICS in eyes with hard cataracts and corneal diameter of 6-8 mm. PE should be considered as the primary choice whenever permissible by the corneal diameter and severity of nuclear sclerosis. Poor functional outcomes were seen in eyes with smaller corneal diameter, extensive chorioretinal coloboma, and intraoperative complications.
本研究旨在报告合并先天性虹膜脉络膜缺损的白内障手术的结果，并确定具有重要预后意义的因素。
回顾性分析 2016 年 1 月至 2018 年 12 月期间在合并先天性虹膜脉络膜缺损的白内障患者中接受白内障手术的患者的病历。
在研究期间，330231 例手术中，276 例患者的 280 只眼合并先天性虹膜脉络膜缺损。白内障手术中先天性虹膜脉络膜缺损的患病率为 0.085%。患者的平均年龄为 46.4 岁（19-88 岁）。130 只眼（46.4%）行超声乳化白内障吸除术（PE），115 只眼（41.1%）行手动小切口白内障囊外摘除术（M-SICS），35 只眼（12.5%）行白内障囊内摘除术。术中并发症发生于 26 只眼（9%）。PE 组和 M-SICS 组术中及术后并发症的发生率相当（p=0.94）。平均矫正视力（CDVA）从 logMAR 1.71±0.62 提高到 0.87±0.61（p=0.00009）。多因素分析显示，小角膜（p=0.002）、1 型和 2 型先天性虹膜脉络膜缺损（p<0.001）和术中并发症（p=0.001）与视力不良有关。
对于软性白内障和角膜直径>8mm 的眼，可采用超声乳化白内障吸除术；对于硬性白内障和角膜直径为 6-8mm 的眼，可采用手动小切口白内障囊外摘除术，获得良好的功能结果。只要角膜直径和核性白内障的严重程度允许，超声乳化白内障吸除术应作为首选。对于角膜直径较小、脉络膜视网膜缺损广泛以及术中并发症的眼，视力结果较差。
