Zhang Xi-Fang, Li Xiao-Xia, Xin Chen, Kline Brad, Kang Meng-Tian, Li Meng, Qiao Li-Ya, Wang Ning-Li
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States.
Front Med (Lausanne). 2022 Apr 15;9:739197. doi: 10.3389/fmed.2022.739197. eCollection 2022.
By reporting clinical characteristics and retinal image quality before and after refractive lens replacement surgery in early-onset high myopia (eoHM) patients presenting with partial cataract, we emphasized the need for an objective way to grade the severity of partial cataracts.
This retrospective, consecutive case series included six Chinese patients (nine eyes). Analysis of previous medical records, visual acuity, optometry, retinal image quality, and axial length (AXL) before surgery and after surgery was performed.
Five females and one male (nine eyes) with a mean (± SD) age of 11.6 ± 7.9 years (range: 4-25 years) were included in this study. The preoperative spherical power ranged from -7.5 to -42 D. The mean follow-up time was 36 months (range: 24-48 months). Phacoemulsification was followed by in-the-bag implantation of intraocular lens. For patients who were under 6 years old, posterior capsulotomy + anterior vitrectomy were performed simultaneously. All surgeries were uneventful and no postoperative complications occurred during the entire follow-up period. All patients' uncorrected visual acuity improved by ≥2 lines postoperatively(Snellen acuity). LogMAR best-corrected visual acuity was improved at 24-month ( = 0.042) and endpoint ( = 0.046) follow-ups. Modulation transfer function cutoff frequency (MTF) and objective scatter index (OSI) was significantly improved at 12-month ( = 0.025, = 0.038), 24-month ( = 0.005, = 0.007) and endpoint ( = 0.005, = 0.008) follow-ups. Postoperative AXL remained stable during 2-4 year follow-ups ( > 0.05).
Refractive lens replacement surgery is safe and effective for improving functional vision in eoHM patients presenting with partial cataract. Retinal image quality could provide a useful and objective way to facilitate partial cataract severity evaluation and surgery decision making.
通过报告早发性高度近视（eoHM）合并部分性白内障患者屈光性晶状体置换手术前后的临床特征和视网膜图像质量，我们强调了需要一种客观的方法来对部分性白内障的严重程度进行分级。
本回顾性连续病例系列研究纳入了6例中国患者（9只眼）。对术前和术后的既往病历、视力、验光、视网膜图像质量和眼轴长度（AXL）进行了分析。
本研究纳入了5名女性和1名男性（9只眼），平均（±标准差）年龄为11.6±7.9岁（范围：4 - 25岁）。术前球镜度数范围为-7.5至-42 D。平均随访时间为36个月（范围：24 - 48个月）。白内障超声乳化吸除术后行人工晶状体囊袋内植入。对于6岁以下的患者，同时进行了后囊切开术+前部玻璃体切除术。所有手术均顺利，在整个随访期间未发生术后并发症。所有患者术后裸眼视力均提高了≥2行（Snellen视力）。在24个月（=0.042）和随访终点（=0.046）时，LogMAR最佳矫正视力得到改善。在12个月（=0.025，=0.038）、24个月（=0.005，=0.007）和随访终点（=0.005，=0.008）时，调制传递函数截止频率（MTF）和客观散射指数（OSI）显著改善。术后眼轴长度在2 - 4年随访期间保持稳定（>0.05）。
屈光性晶状体置换手术对于改善合并部分性白内障的eoHM患者的功能性视力是安全有效的。视网膜图像质量可为促进部分性白内障严重程度评估和手术决策提供一种有用且客观的方法。
