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巴西公共卫生系统中小儿白内障无晶状体眼原发性人工晶状体植入的手术效果。

Surgical outcomes of primary intraocular lens implantation for the treatment of aphakia in pediatric cataracts in the Brazilian public health system.

机构信息

Department of Surgical Specialties and Anesthesiology, Ophthalmology Division, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.

Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.

出版信息

Arq Bras Oftalmol. 2023 May-Jun;86(3):210-216. doi: 10.5935/0004-2749.20230045.

Abstract

PURPOSE

To evaluate primary intraocular lens implantation in the treatment of children's aphakia in the Brazilian public health system and compare the outcomes among different age groups.

METHODS

Children aged 0-12 years old with unilateral or bilateral congenital/developmental cataracts and underwent primary intraocular lens implantation were included.

RESULTS

A total of 108 eyes from 68 children were evaluated, and the children were divided into four age groups (<7 months [mo]; 7 mo-2 years old [y/o]; 2-5 y/o, and >5 y/o) were evaluated. Nineteen eyes (17.59%) presented visual axis opacification as a postoperative complication, which was more frequently observed in the <7 mo age group (37.93%). The difference was significant between the <7 mo and >5 y/o age groups (p=0.002). Visual axis opacification was divided into two categories: pupillary membrane and lens cell proliferation. Eight eyes presented pupillary membrane, whereas 14 showed lens cell proliferation. Out of eight eyes with pupillary membrane, seven occurred in the <7 mo age group. The difference between the <7 mo age group and the 2-5 y/o or >5 y/o age group was significant (p=0.01). Lens cell proliferation was more frequent in the <7 mo and 2-5 y/o age groups, but the difference was significant only between the < 7 mo age group and >5 y/o age group (p=0.040). Glaucoma and glaucoma suspect cases were not observed during the follow-up period.

CONCLUSIONS

The main complication found in the study was visual axis opacification, which had a higher incidence in children operated on or before the age of 7 months.

摘要

目的

评估巴西公共卫生系统中儿童无晶状体眼的原发性人工晶状体植入治疗,并比较不同年龄组的结果。

方法

纳入年龄在 0-12 岁,患有单侧或双侧先天性/发育性白内障并接受原发性人工晶状体植入的儿童。

结果

共评估了 68 名儿童的 108 只眼,将儿童分为 4 个年龄组(<7 个月[mo];7 mo-2 岁[y/o];2-5 y/o,和>5 y/o)。19 只眼(17.59%)出现术后视觉轴混浊等并发症,<7 mo 年龄组发生率较高(37.93%)。<7 mo 组与>5 y/o 组之间差异有统计学意义(p=0.002)。视觉轴混浊分为瞳孔膜和晶状体细胞增生两种类型。8 只眼出现瞳孔膜,14 只眼出现晶状体细胞增生。8 只瞳孔膜中,7 只发生在<7 mo 年龄组。<7 mo 年龄组与 2-5 y/o 或>5 y/o 年龄组之间差异有统计学意义(p=0.01)。<7 mo 和 2-5 y/o 年龄组晶状体细胞增生更常见,但仅在<7 mo 年龄组与>5 y/o 年龄组之间差异有统计学意义(p=0.040)。随访期间未观察到青光眼和青光眼疑似病例。

结论

本研究中主要并发症为视觉轴混浊,7 个月以内手术的儿童发生率较高。

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