From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Liu, Lian, Ng, Zhang, Zheng, Jin); Albany Medical College, Albany, New York (Young).
J Cataract Refract Surg. 2024 Feb 1;50(2):134-139. doi: 10.1097/j.jcrs.0000000000001326.
To evaluate the postoperative longitudinal refractive changes in children younger than 8 years with ectopia lentis and Marfan syndrome (MFS).
Zhongshan ophthalmic center, Guangzhou, China.
Retrospective cohort study.
Medical data of patients diagnosed with ectopia lentis and MFS that underwent surgery younger than 8 years were collected. Refractive errors and ocular biometric parameters were collected preoperatively and at each follow-up visit. Patients were stratified into groups according to age at surgery, and only the eye operated on first was selected. Multivariate analysis was performed to determine the association between refractive shift and potential risk factors.
In total, 54 eyes of 54 patients were enrolled. The median age at surgery was 6.21 years (interquartile range [IQR], 5.25 to 6.85), and the median follow-up was 2.0 years (IQR, 1.2 to 2.8 years). At age 8 years, patients demonstrated a median myopic shift ranged from -1.75 diopters (D) (IQR, -2.75 to -1.00 D) for the 4-year-old group to -0.13 D (IQR, -0.50 to -0.06 D) for the 7-year-old group. Multivariate analysis showed that greater myopic shift was associated with younger age at surgery ( P = .004), male sex ( P = .026), and shorter preoperative axis length ( P = .005).
A tendency toward increasing postoperative myopic was demonstrated in children with ectopia lentis and MFS, with the greatest myopic shift in the younger age groups. If the goal is to reach emmetropia by age 8 years, the immediate postoperative hypermetropic targets should be 1.75 D for age 4 years, 1 D for age 5 years, 0.5 D for age 6 years, and 0 to 0.25 D for age 7 years.
评估 8 岁以下晶状体异位和马凡综合征（MFS）患儿术后的纵向屈光变化。
中国广州中山大学眼科中心。
回顾性队列研究。
收集诊断为晶状体异位和 MFS 并在 8 岁以下接受手术的患者的医疗数据。收集术前和每次随访时的屈光不正和眼生物测量参数。根据手术年龄将患者分为不同的组，仅选择首次手术的眼。进行多变量分析以确定屈光变化与潜在危险因素之间的关系。
共纳入 54 例 54 只眼。手术时的中位年龄为 6.21 岁（四分位距 [IQR]，5.25 至 6.85），中位随访时间为 2.0 年（IQR，1.2 至 2.8 年）。在 8 岁时，4 岁组的患者表现出中位数为-1.75 屈光度（D）（IQR，-2.75 至-1.00 D）的近视漂移，而 7 岁组为-0.13 D（IQR，-0.50 至-0.06 D）。多变量分析显示，较大的近视漂移与手术年龄较小（P =.004）、男性（P =.026）和较短的术前眼轴长度（P =.005）相关。
晶状体异位和 MFS 患儿术后有近视增加的趋势，年龄较小的组近视漂移最大。如果目标是在 8 岁时达到正视，那么 4 岁时的术后远视目标应为 1.75 D，5 岁时为 1 D，6 岁时为 0.5 D，7 岁时为 0 至 0.25 D。
