Chang Pingjun, Li Siyan, Wang Dandan, Chen Chaoqiao, Fu Yana, Hu Man, Qian Shuyi, Zhao Yun-E
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China.
Front Pediatr. 2023 Apr 12;11:1124030. doi: 10.3389/fped.2023.1124030. eCollection 2023.
To describe neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser treatment of visual axis opacification and secondary membranes in pediatric patients with cataracts under intranasal dexmedetomidine sedation.
Twenty eyes of 17 patients with secondary membrane formation after cataract extraction were enrolled in this study. Intranasal dexmedetomidine sedation (3 ug/kg) was administered, and Nd:YAG laser (Ellex Super Q, Adelaide, Australia) procedures were performed with children in the sitting position with their chin supported on a laser delivery slit lamp. Preoperative and postoperative visual acuities were documented, and medical records were reviewed.
The age of the patients ranged from 5 to 83 months (31.82 ± 27.73). Nineteen (95.0%) eyes had congenital cataracts and one (5.0%) had a traumatic cataract. Nd:YAG laser treatment of VAO with ten (50.0%) eyes, pupillary membranes with three (15.0%) eyes, pupillary cortical proliferation with six (30.0%) eyes, and anterior capsule contraction with one (5.0%) eye. Five (25.0%) eyes demonstrated visual acuity improvement, whereas six (30.0%) eyes remained unchanged after laser treatment. The recurrence rate was 30.0% and four eyes underwent a second Nd:YAG membranectomy. No side effects or tolerances due to sedative drugs were observed.
Nd:YAG laser membranectomy under intranasal dexmedetomidine sedation was safely performed in children as young as 5 months old in a sitting position. This approach facilitates patient convenience, doctor proficiency, and cost reductions. Patients with recurrence can be treated by repeating the procedure.
描述在鼻内给予右美托咪定镇静的情况下，用掺钕钇铝石榴石（Nd:YAG）激光治疗小儿白内障患者视轴混浊和继发性膜。
本研究纳入了17例白内障摘除术后形成继发性膜的患者的20只眼。给予鼻内右美托咪定镇静（3μg/kg），Nd:YAG激光（澳大利亚阿德莱德的Ellex Super Q）手术在患儿坐位时进行，下巴支撑在激光传输裂隙灯上。记录术前和术后视力，并查阅病历。
患者年龄范围为5至83个月（31.82±27.73）。19只眼（95.0%）为先天性白内障，1只眼（5.0%）为外伤性白内障。Nd:YAG激光治疗视轴混浊10只眼（50.0%）、瞳孔膜3只眼（15.0%）、瞳孔皮质增生6只眼（30.0%）、前囊收缩1只眼（5.0%）。5只眼（25.0%）视力改善，6只眼（30.0%）激光治疗后视力无变化。复发率为30.0%，4只眼接受了第二次Nd:YAG膜切除术。未观察到镇静药物引起的副作用或耐受性。
在鼻内右美托咪定镇静下，Nd:YAG激光膜切除术可在5个月大的小儿坐位时安全进行。这种方法方便患者、提高医生操作熟练度并降低成本。复发患者可通过重复该手术进行治疗。
