Wang Dan-Dan, Li Zhang-Liang, Zhang Bing, Lu Zi-Yi, Guan Wei-Chen, Zhao Yun-E
Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
National Clinical Research Center for Ocular Disease, Wenzhou 325027, Zhejiang Province, China.
Int J Ophthalmol. 2022 Sep 18;15(9):1453-1459. doi: 10.18240/ijo.2022.09.07. eCollection 2022.
To evaluate morphological changes in the iridocorneal angle after pediatric cataract surgery.
Children who underwent primary infantile cataract surgery were included and 64 eyes from 41 children, including 18 with unilateral cataracts (18 eyes) and 23 with bilateral cataracts (46 eyes) were examined. All patients underwent two gonioscopic examinations to evaluate the iridocorneal angle, before the primary lens removal and before the secondary intraocular lens implantation. The anatomical changes in the iridocorneal angle and the relationship between intraocular pressure (IOP) and iridocorneal angle changes were also analyzed.
The iridocorneal angle was wide in 64 eyes before and after surgery. The trabecular meshwork pigmentation, number of iris processes in every quadrant of the iridocorneal angle, and the width of the ciliary body band in the superior and inferior quadrants at the second gonioscopic examination were significantly increased compared to those at the first examination (<0.001, <0.05, <0.05, and <0.05, respectively). IOP gradually increased at 1mo after operation, and returned to the preoperative level at 3mo. However, IOP still increased significantly at 6 and 12mo.
The main changes after pediatric cataract surgery include an increase in trabecular meshwork pigmentation and number of iris processes, IOP gradually increase and has positive correlation with trabecular meshwork pigmentation and anterior insertion of iris process.
评估小儿白内障手术后虹膜角膜角的形态学变化。
纳入接受原发性婴儿白内障手术的儿童，对41名儿童的64只眼进行检查，其中包括18名单侧白内障患儿（18只眼）和23名双侧白内障患儿（46只眼）。所有患者在初次晶状体摘除术前和二期人工晶状体植入术前均接受两次前房角镜检查以评估虹膜角膜角。还分析了虹膜角膜角的解剖学变化以及眼压（IOP）与虹膜角膜角变化之间的关系。
手术前后64只眼的虹膜角膜角均较宽。与第一次检查相比，第二次前房角镜检查时小梁网色素沉着、虹膜角膜角各象限的虹膜突数量以及上下象限睫状体带宽度均显著增加（分别为<0.001、<0.05、<0.05和<0.05）。术后1个月眼压逐渐升高，3个月时恢复到术前水平。然而，眼压在6个月和12个月时仍显著升高。
小儿白内障手术后的主要变化包括小梁网色素沉着和虹膜突数量增加，眼压逐渐升高，且与小梁网色素沉着和虹膜突向前插入呈正相关。
