Wood Alanna, Lim Benjamin, Matthews Jim, Karaconji Tanya, Zagora Sophia L, Jamieson Robyn V, Grigg John R, Jones Michael, Rowe Neil, Hing Stephen, Donaldson Craig, Smith James E H
Save Sight Institute, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, Sydney, NSW, Australia.
Department of Ophthalmology, The Children's Hospital at Westmead, Sydney, Australia.
Clin Ophthalmol. 2023 Jul 31;17:2171-2179. doi: 10.2147/OPTH.S400512. eCollection 2023.
Secondary glaucoma following childhood cataract surgery remains the most common complication in the paediatric population. This study aimed to determine the incidence, time to progression and risk factors associated with the development of secondary glaucoma following childhood cataract surgery in a paediatric population. Outcome measures were the detection of secondary glaucoma, postoperative time frame to development of glaucoma and risk factors in its development.
A retrospective case series was conducted between 2003 and 2017 at a tertiary children's hospital in Sydney. The patient population included those 16 years or less of age who underwent congenital cataract extraction, with or without an intraocular lens implantation and who had been followed up for a minimum of six months following surgery. Patients were excluded if they had cataract aetiology other than congenital idiopathic cataract. Multivariate Cox Regression analysis was used to determine relevant risk factors.
A total of 320 eyes in 216 patients were included in the study. Secondary glaucoma developed in 11.9% of eyes. In those that developed secondary glaucoma, the average time to onset from surgery was 3.2 years (median 2.75 years). The mean age of diagnosis of secondary glaucoma was 4.58 years (median 3.5 years, range 2.5 months to 13.23 years). Microcornea was the only adverse characteristic significantly associated with an increased risk of secondary glaucoma (HR 6.30, p 0.003).
Despite modern surgical techniques, glaucoma remains a significant long-term sequela in children following cataract surgery.
儿童白内障手术后继发性青光眼仍然是儿科人群中最常见的并发症。本研究旨在确定儿科人群中儿童白内障手术后继发性青光眼的发病率、进展时间及相关危险因素。观察指标为继发性青光眼的检测、青光眼发生的术后时间范围及其发生的危险因素。
2003年至2017年在悉尼一家三级儿童医院进行了一项回顾性病例系列研究。患者群体包括16岁及以下接受先天性白内障摘除术的患者,无论是否植入人工晶状体,且术后至少随访6个月。如果患者患有先天性特发性白内障以外的其他白内障病因,则将其排除。采用多因素Cox回归分析来确定相关危险因素。
本研究共纳入216例患者的320只眼。11.9%的眼睛发生了继发性青光眼。在发生继发性青光眼的患者中,从手术到发病的平均时间为3.2年(中位数2.75年)。继发性青光眼的平均诊断年龄为4.58岁(中位数3.5岁,范围2.5个月至13.23岁)。小角膜是与继发性青光眼风险增加显著相关的唯一不良特征(风险比6.30,p = 0.003)。
尽管有现代手术技术,但青光眼仍然是儿童白内障手术后的一个重要长期后遗症。