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小儿白内障手术中无需前部玻璃体切割的光学捕获

Optic Capture Without Anterior Vitrectomy in Pediatric Cataract Surgery.

作者信息

Devebacak Ali, Biler Elif Demirkilinc, Degirmenci Cumali, Uretmen Onder

机构信息

From the Department of Ophthalmology, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital (A.D.).

and Ege University, Department of Ophthalmology (E.D.B., C.D., O.U.), Izmir, Turkey.

出版信息

Am J Ophthalmol. 2023 Mar;247:88-95. doi: 10.1016/j.ajo.2022.11.007. Epub 2022 Nov 12.

Abstract

PURPOSE

To compare outcomes of 2 surgical techniques in children undergoing cataract surgery with intraocular lens (IOL) implantation: optic capture of IOL without anterior vitrectomy (AV) or in-the-bag IOL with AV.

DESIGN

Prospective randomized controlled trial.

METHODS

Patients were randomized to 2 groups: optic capture without AV (group 1) or in-the-bag implantation with AV (group 2). The following variables were compared: visual axis opacification (VAO), inflammatory deposits on IOL surface, anteroposterior synechia, IOL tilt and decentration, lenticular astigmatism, refractive prediction error, and posterior segment complications.

RESULTS

Fifty-one eyes of 37 children were investigated with a mean follow-up of 20.1±8.5 months. Group 1 and group 2 had mean ages of 59.2±32.6 and 46.5±21.9 months, respectively (P = .104). Three eyes in group 1 and 2 eyes in group 2 developed VAO (P = .656). Two eyes in group 1 and 5 eyes in group 2 developed anteroposterior synechia (P = .291). Six eyes in group 1 and 11 eyes in group 2 had inflammatory deposits on the IOL (P = .233). Both groups had similar IOL tilt and decentralization (for all meridians, P > .05). The absolute refractive prediction error was 0.55±0.34 diopter (D) and 0.53±0.3 D, respectively (P = .294). Each group had 1 eye with intraocular hypertension (P = .932).

CONCLUSION

The optic capture method was similar to the conventional technique in the quantitative evaluation of comprehensive data such as visual axis opacification, inflammatory sequelae, refractive outcomes, and IOL stability. The optic capture technique is an appealing option for pediatric cataract surgery because it eliminates the requirement for vitrectomy.

摘要

目的

比较两种手术技术在接受白内障手术并植入人工晶状体(IOL)的儿童中的手术效果:不进行前部玻璃体切除术(AV)的IOL光学部捕获术或进行AV的囊袋内IOL植入术。

设计

前瞻性随机对照试验。

方法

将患者随机分为两组:不进行AV的光学部捕获术组(第1组)或进行AV的囊袋内植入术组(第2组)。比较以下变量:视轴混浊(VAO)、IOL表面的炎性沉积物、前后粘连、IOL倾斜和偏心、晶状体散光、屈光预测误差以及后段并发症。

结果

对37名儿童的51只眼进行了研究,平均随访时间为20.1±8.5个月。第1组和第2组的平均年龄分别为59.2±32.6个月和46.5±21.9个月(P = 0.104)。第1组有3只眼,第2组有2只眼发生了VAO(P = 0.656)。第1组有2只眼,第2组有5只眼发生了前后粘连(P = 0.291)。第1组有6只眼,第2组有11只眼的IOL上有炎性沉积物(P = 0.233)。两组的IOL倾斜和偏心情况相似(所有子午线方向,P>0.05)。绝对屈光预测误差分别为0.55±0.34屈光度(D)和0.53±0.3 D(P = 0.294)。每组各有1只眼发生高眼压(P = 0.932)。

结论

在对视轴混浊、炎性后遗症、屈光结果和IOL稳定性等综合数据的定量评估中,光学部捕获法与传统技术相似。光学部捕获技术是小儿白内障手术的一个有吸引力的选择,因为它无需进行玻璃体切除术。

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