Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden.
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Ophthalmol. 2023 Mar;101(2):170-176. doi: 10.1111/aos.15241. Epub 2022 Aug 29.
The aim of this study was to determine the prevalence of late-onset glaucoma after surgery for congenital cataract in a cohort with long-term follow-up and to evaluate visual development following the diagnosis of postoperative glaucoma in comparison with no glaucoma development.
All children born between 1980 and 1997 in the western counties of Sweden who had undergone congenital cataract surgery were included (patients n = 77, eyes n = 122). Cataract was considered congenital if there was no proof of clear lens at birth. Medical records were reviewed with regard to onset of glaucoma, age at surgery, surgical technique, coexisting eye anomalies and changes in visual acuity. Glaucoma was considered late onset if occurring after 1 year following surgery.
Total glaucoma prevalence was 14.8%, including late (10.7%) and early onset (4.1%), with a mean follow-up of 23.2 ± 6.6 years. Microphthalmos was a significant risk factor for developing glaucoma (RR 7.75, p < 0.001). Bilaterally treated eyes had a mean visual acuity of 0.43 ± 0.33 (decimal value) at the last follow-up. With glaucoma, mean visual acuity was 0.19 ± 0.17 (decimal value). Treated eyes of patients with unilateral cataract surgery had a lower visual acuity.
Life-long follow-up of all patients who have undergone surgery for congenital cataract in childhood is recommended. Annual check-ups of adults, including measurements of IOP and visual acuity, are recommended for patients with microphthalmos and/or who had surgery <3 months of age.
本研究旨在确定长期随访的先天性白内障手术后迟发性青光眼的患病率，并评估术后诊断为青光眼与无青光眼发展的视觉发育情况。
纳入 1980 年至 1997 年期间在瑞典西部县出生并接受先天性白内障手术的所有儿童（患者 n=77，眼 n=122）。如果出生时没有晶状体清晰的证据，则认为白内障为先天性。回顾了病历，以了解青光眼的发病时间、手术年龄、手术技术、并存的眼部异常和视力变化。如果在手术后 1 年以后发生青光眼，则认为是迟发性。
总青光眼患病率为 14.8%，包括晚期（10.7%）和早期（4.1%），平均随访时间为 23.2±6.6 年。小眼球是发生青光眼的显著危险因素（RR 7.75，p<0.001）。双侧治疗眼的最后一次随访时平均视力为 0.43±0.33（十进制值）。患有青光眼的眼，平均视力为 0.19±0.17（十进制值）。接受单侧白内障手术治疗的眼视力较低。
建议对所有儿童期接受先天性白内障手术的患者进行终身随访。对于小眼球和/或手术年龄<3 个月的患者，建议成年人每年进行眼压和视力检查。
