Lin Duoru, Zhu Qiaolin, Zhang Shuyi, Zhou Fengqi, Zhao Lanqin, Wang Qiwei, Chen Wan, Chen Hui, Lin Xiaoshan, Feng Huanling, Zhong Qiuping, Chen Jingjing, Lin Zhuoling, Li Xiaoyan, Xiao Wei, Zhou Yue, Wang Jinghui, Li Jing, Chen Weirong
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.
Mayo Clinic College of Medicine and Science, Rochester, MN, United States.
Front Med (Lausanne). 2024 May 2;11:1406287. doi: 10.3389/fmed.2024.1406287. eCollection 2024.
This study aimed to explore the postoperative myopic shift and its relationship to visual acuity rehabilitation in patients with bilateral congenital cataracts (CCs).
Bilateral CC patients who underwent cataract extraction and primary intraocular lens implantations before 6 years old were included and divided into five groups according to surgical ages (<2, 2-3, 3-4, 4-5, and 5-6 years). The postoperative myopic shift rates, spherical equivalents (SEs), and the best corrected visual acuity (BCVA) were measured and analyzed.
A total of 1,137 refractive measurements from 234 patients were included, with a mean follow-up period of 34 months. The postoperative mean SEs at each follow-up in the five groups were linearly fitted with a mean = 0.93 ± 0.03, which showed a downtrend of SE with age (linear regression). Among patients with a follow-up of 4 years, the mean postoperative myopic shift rate was 0.84, 0.81, 0.68, 0.24, and 0.28 diopters per year (D/y) in the five age groups (from young to old), respectively. The BCVA of those with a surgical age of <2 years at the 4-year visit was 0.26 (LogMAR), and the mean postoperative myopic shift rate was 0.84 D/y. For patients with a surgical age of 2-6 years, a poorer BCVA at the 4-year visit was found in those with higher postoperative myopic shift rates ( = 0.974, = 0.026, Pearson's correlation test).
Performing cataract surgery for patients before 2 years old and decreasing the postoperative myopic shift rates for those with a surgical age of 2-6 years may benefit visual acuity rehabilitation.
本研究旨在探讨双侧先天性白内障（CC）患者术后近视性移位及其与视力恢复的关系。
纳入6岁前接受白内障摘除及一期人工晶状体植入术的双侧CC患者，并根据手术年龄（<2岁、2 - 3岁、3 - 4岁、4 - 5岁和5 - 6岁）分为五组。测量并分析术后近视性移位率、等效球镜度（SE）和最佳矫正视力（BCVA）。
共纳入234例患者的1137次屈光测量，平均随访期为34个月。五组患者每次随访时的术后平均SE进行线性拟合，均值 = 0.93 ± 0.03，显示SE随年龄呈下降趋势（线性回归）。在随访4年的患者中，五个年龄组（从年轻到年老）术后每年的平均近视性移位率分别为0.84、0.81、0.68、0.24和0.28屈光度（D/y）。手术年龄<2岁的患者在4年随访时的BCVA为0.26（LogMAR），术后平均近视性移位率为0.84 D/y。对于手术年龄为2 - 6岁的患者，在4年随访时，术后近视性移位率较高者的BCVA较差（ = 0.974， = 0.026，Pearson相关检验）。
对2岁前的患者进行白内障手术，并降低手术年龄为2 - 6岁患者的术后近视性移位率，可能有利于视力恢复。
