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小儿外伤性白内障:一家三级转诊中心的 10 年经验。

Pediatric traumatic cataracts: 10-year experience of a tertiary referral center.

机构信息

Department of Ophthalmology, University of Health Sciences, Dr. Lütfi Kırdar Kartal City Hospital, Denizer Cad. No:1, 34865, Cevizli, 34100, İstanbul, Turkey.

Department of Ophthalmology, Afyonkarahisar University of Health Sciences, 03200, Afyonkarahisar, Turkey.

出版信息

BMC Ophthalmol. 2022 May 2;22(1):199. doi: 10.1186/s12886-022-02427-6.

Abstract

BACKGROUND

This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts.

METHODS

Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications.

RESULTS

In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures.

CONCLUSIONS

In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies.

摘要

背景

本研究旨在评估影响儿童外伤性白内障最终视力的因素。

方法

回顾性分析外伤性白内障患者的资料。评估外伤时的年龄;性别、外伤类型、原因和部位;外伤至白内障手术的时间间隔;手术方法;人工晶状体(IOL)植入的时间、部位和类型;初始和最终最佳矫正视力(BCVA);弱视发生率;以及并发症。

结果

共纳入 59 例年龄<16 岁外伤性白内障患儿的 61 只眼。儿童平均年龄为 7.2±3.9 岁。70.9%的眼行一期 IOL 植入。49 只可测量伤时视力的眼中,5.9%的视力为 0.7 LogMAR 或更好,55 只可测量治疗后视力的眼中,69.1%的视力为 0.7 LogMAR 或更好。评估可能影响最终视力的因素发现,白内障手术中进行后囊膜切开(PC)和前段玻璃体切割(AV)的眼最终视力明显优于未行此操作的眼。

结论

在儿童外伤性白内障患者中,最终视力不受患者年龄和性别、外伤类型、原因和部位、外伤至白内障手术的时间间隔、手术方法以及 IOL 植入的时间、部位和类型的影响。仅通过 PC+AV 联合晶状体抽吸术,无论是否植入 IOL,才能改善最终 BCVA。然而,这种弱视治疗方法需要通过更全面和前瞻性的研究来证实。

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