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双眼先天性白内障手术后的并发症和眼轴增长:小眼球眼与对照组比较。

Postoperative complications and axial length growth after bilateral congenital cataract surgery: eyes with microphthalmos compared to a comparison group.

机构信息

Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.

National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Eye (Lond). 2024 Oct;38(15):2912-2919. doi: 10.1038/s41433-024-03176-0. Epub 2024 Jun 21.

DOI:10.1038/s41433-024-03176-0
PMID:38907015
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11461963/
Abstract

PURPOSE

To investigate the postoperative clinical outcomes and axial length (AL) growth of infants with congenital cataracts and microphthalmos following first-stage cataract surgery.

DESIGN

Retrospective case-control study.

METHODS

Setting: Single centre. Infants with congenital cataract that met the inclusion criteria were classified into two groups: the microphthalmos and comparison groups. All infants underwent a thorough ophthalmologic examination before surgery, and one week, 1 month, 3 months, and every 3 months after surgery.

RESULTS

This study enrolled 21 infants (42 eyes) in the microphthalmos group and 29 infants (58 eyes) in the comparison group. More glaucoma-related adverse events were observed in the microphthalmos group (7 eyes, 16.7%) than in the comparison group (0 eyes, 0%) (p < 0.001). At each subsequent follow-up, the comparison group had a greater AL than the microphthalmos group (all p < 0.001), and AL growth was significantly higher in the comparison group than in the microphthalmos group (all p = 0.035). Visual acuity improvement in the microphthalmos group was similar to that of the comparison group.

CONCLUSION

Early surgical intervention improves visual function in infants with congenital cataracts and microphthalmos although with a higher incidence of glaucoma-related adverse events. After cataract removal, the AL growth of microphthalmic eyes is slower than that of normally developed eyes.

摘要

目的

研究一期白内障手术后先天性白内障合并小眼球婴儿的术后临床结果和眼轴(AL)生长情况。

设计

回顾性病例对照研究。

方法

研究地点:单中心。符合纳入标准的先天性白内障婴儿分为两组:小眼球组和对照组。所有婴儿在手术前、手术后 1 周、1 个月、3 个月和每 3 个月进行全面眼科检查。

结果

本研究纳入 21 例(42 只眼)小眼球组和 29 例(58 只眼)对照组婴儿。小眼球组(7 只眼,16.7%)发生青光眼相关不良事件的比例高于对照组(0 只眼,0%)(p<0.001)。在随后的每次随访中,对照组的 AL 均大于小眼球组(均 p<0.001),对照组的 AL 增长速度明显快于小眼球组(均 p=0.035)。小眼球组的视力改善与对照组相似。

结论

尽管先天性白内障合并小眼球婴儿发生青光眼相关不良事件的风险较高,但早期手术干预可改善其视觉功能。白内障切除后,小眼球眼的 AL 生长速度慢于正常发育眼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c73/11461963/7545710deaef/41433_2024_3176_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c73/11461963/7545710deaef/41433_2024_3176_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c73/11461963/7545710deaef/41433_2024_3176_Fig1_HTML.jpg

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2
Incidence of and risk factors for suspected and definitive glaucoma after bilateral congenital cataract surgery: a 5-year follow-up.双侧先天性白内障手术后疑似和明确青光眼的发生率及危险因素:5 年随访。
Br J Ophthalmol. 2024 Feb 21;108(3):476-483. doi: 10.1136/bjo-2022-322589.
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Incidence of Glaucoma-Related Adverse Events in the First 5 Years After Pediatric Lensectomy.
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JAMA Ophthalmol. 2023 Apr 1;141(4):324-331. doi: 10.1001/jamaophthalmol.2022.6413.
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Late-onset glaucoma following congenital cataract surgery: Occurrence, visual acuity and risk factors: A 37-year longitudinal follow-up.先天性白内障手术后迟发性青光眼:发生、视力和危险因素:37 年的纵向随访。
Acta Ophthalmol. 2023 Mar;101(2):170-176. doi: 10.1111/aos.15241. Epub 2022 Aug 29.
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