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.
Transl Vis Sci Technol. 2024 May 1;13(5):24. doi: 10.1167/tvst.13.5.24.
To evaluate the association between preoperative ocular parameters and myopic shift following primary intraocular lens (IOL) implantation in pediatric cataracts.
Eyes from pediatric patients undergoing bilateral cataract surgery with primary IOL implantation were included. Eyes were grouped by age at surgery and subdivided into three axial length (AL) subgroups and three keratometry subgroups. Mixed-effects linear regression was utilized to assess the trend in myopic shift among subgroups. Multivariable analysis was performed to determine factors associated with myopic shift.
A total of 222 eyes were included. The median age at surgery was 4.36 years (interquartile range [IQR], 3.16-6.00 years) and the median follow-up was 4.18 years (IQR, 3.48-4.64 years). As preoperative AL increased, a decreased trend was observed in myopic shift and rate of myopic shift (P = 0.008 and P = 0.003, respectively, in the 4 to <6 years old group; P = 0.002 and P < 0.001, respectively, in the ≥6 years old group). Greater myopic shift and rate of myopic shift were associated with younger age at surgery (P = 0.008 and P = 0.008, respectively). Both myopic shift and rate of myopic shift were negatively associated with AL.
Age at surgery and preoperative AL were associated with myopic shift in pediatric cataracts following primary IOL implantation. Adjusting the target refraction based on preoperative AL could potentially improve patients' long-term refractive outcome.
This study may help to guide the selection of postoperative target refraction according to age at surgery and preoperative ocular parameters for pediatric cataracts.
评估儿童白内障患者行一期人工晶状体（IOL）植入术后术前眼部参数与近视漂移的相关性。
纳入行双眼白内障手术并一期 IOL 植入术的儿童患者。根据手术时的年龄将眼分组，并进一步根据眼轴长度（AL）和角膜曲率分为三个亚组。采用混合效应线性回归评估各亚组间近视漂移的趋势。采用多变量分析确定与近视漂移相关的因素。
共纳入 222 只眼。手术时的中位年龄为 4.36 岁（四分位距[IQR]，3.16-6.00 岁），中位随访时间为 4.18 年（IQR，3.48-4.64 年）。随着术前 AL 的增加，近视漂移和近视漂移率呈下降趋势（4 至<6 岁组，P = 0.008 和 P = 0.003；≥6 岁组，P = 0.002 和 P < 0.001）。手术年龄越小，近视漂移和近视漂移率越大（P = 0.008 和 P = 0.008）。近视漂移和近视漂移率均与 AL 呈负相关。
手术年龄和术前 AL 与儿童白内障一期 IOL 植入术后的近视漂移有关。根据术前 AL 调整目标屈光度可能会改善患者的长期屈光结果。
曹帅
