Sabr Mawaddah, Semidey Valmore A, Rubio-Caso Marcos J, Aljuhani Jnr Renad, Sesma Gorka
Pediatric Ophthalmology and Strabismus Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Clin Ophthalmol. 2024 Jun 5;18:1623-1636. doi: 10.2147/OPTH.S464005. eCollection 2024.
Retinal detachment is a major postsurgical threat in pediatric cataract surgery; however, the effect of axial length remains unclear. This study aimed to assess the relationship between axial length and detachment risk in vulnerable patients.
This retrospective cohort study analyzed 132 eyes of 84 pediatric cataract surgery patients aged <20 years old. Axial length was measured preoperatively, and the incidence of retinal detachment was recorded over a median follow-up of 4 years. Logistic regression analysis was used to examine the axial length-detachment relationship.
Twenty eyes had postoperative retinal detachments. The median axial length was longer in the detachment group (23.6 mm) than in the non-detachment group (21.6 mm). Eyes with axial length ≤23.4 mm had 0.55-fold decreased odds of detachment compared to longer eyes. Preexisting myopia and glaucoma confer heightened risk. Approximately half of the patients retained some detachment risk eight years postoperatively.
Shorter eyes (axial length ≤23.4 mm) appear to be protected against pediatric retinal detachment after cataract surgery, whereas myopia, glaucoma, and axial elongation > 23.4 mm elevate the postoperative risk. Understanding these anatomical risk profiles requires surgical planning and follow-up care of children undergoing lensectomy.
视网膜脱离是小儿白内障手术术后的一个主要威胁；然而，眼轴长度的影响仍不明确。本研究旨在评估易患患者的眼轴长度与视网膜脱离风险之间的关系。
这项回顾性队列研究分析了84例年龄小于20岁的小儿白内障手术患者的132只眼。术前测量眼轴长度，并记录中位随访4年期间视网膜脱离的发生率。采用逻辑回归分析来研究眼轴长度与视网膜脱离的关系。
20只眼发生了术后视网膜脱离。视网膜脱离组的中位眼轴长度（23.6mm）长于未发生视网膜脱离组（21.6mm）。与眼轴较长的眼睛相比，眼轴长度≤23.4mm的眼睛发生视网膜脱离的几率降低了0.55倍。既往近视和青光眼会增加风险。大约一半的患者在术后八年仍有一定的视网膜脱离风险。
较短的眼睛（眼轴长度≤23.4mm）似乎在白内障手术后可预防小儿视网膜脱离，而近视、青光眼和眼轴伸长>23.4mm会增加术后风险。了解这些解剖学风险特征对于接受晶状体切除术的儿童的手术规划和随访护理至关重要。
