Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Department of Statistics, Federal University of Bahia, Salvador, Bahia, Brazil.
Indian J Ophthalmol. 2024 Nov 1;72(Suppl 5):S734-S740. doi: 10.4103/IJO.IJO_212_24. Epub 2024 Aug 14.
To investigate predictors for myopic shift after pediatric cataract surgery after at least 3 years follow-up.
Cross-sectional and retrospective study.
This study included patients treated for congenital or infantile cataract operated up to 5 years of age between 2010 and 2017. Patients were recruited for ophthalmologic evaluation. Surgical and medical data were acquired in medical charts.
Univariate and multivariate regressions were performed to look for potential risk factors for myopic shift.
This study evaluated 81 eyes of 50 patients, with 62 (77%) being bilateral cases, 48 (59%) with intraocular lens implantation, and 37 (74%) patients being strabismic. Age at surgery was 7.7 (3.7-30.5) months and at evaluation was 93.5 (55.1-113.0) months. Total myopic shift was -4.32 ± 3.25 D, significantly greater in patients operated on up to 6 months of life (-5.73 ± 3.14 D). The distant best-corrected visual acuity (BCVA) was 0.6 (0.3-1.0) log of minimum angle of resolution (logMAR). Regarding myopic shift, in univariate analysis, older age at surgery is a protective factor (+0.08 D for each month older, P = 0.001). The presence of strabismus (-2.52 D, P = 0.014), aphakia (-2.45 D, P = 0.006), distant BCVA (-0.15 D per 0.1 logMAR, P = 0.024), and surgical complications (-3.02 D, P = 0.001) are risk factors. In multivariate analysis, older age at surgery (+0.06 D, P = 0.012) and surgical complications (-2.52 D, P = 0.001) remain significant.
In pediatric cataract surgery, myopic shift is greater when surgery is performed in a younger age and if associated with surgical complications.
探讨至少 3 年随访后儿童白内障手术后近视漂移的预测因素。
横断面和回顾性研究。
本研究纳入了 2010 年至 2017 年间接受先天性或婴儿期白内障手术治疗、年龄在 5 岁以下的患者。患者接受眼科评估。手术和医疗数据从病历中获得。
进行单变量和多变量回归以寻找近视漂移的潜在危险因素。
本研究共评估了 50 例患者的 81 只眼，其中 62 只（77%）为双眼病例，48 只（59%）植入了人工晶状体，37 只（74%）为斜视患者。手术时年龄为 7.7（3.7-30.5）个月，评估时年龄为 93.5（55.1-113.0）个月。总近视漂移为-4.32±3.25 D，6 个月内手术患者的漂移值更大（-5.73±3.14 D）。远距最佳矫正视力（BCVA）为 0.6（0.3-1.0）对数最小角分辨率（logMAR）。关于近视漂移，单变量分析显示，手术时年龄较大是一个保护因素（每增加 1 个月，增加 0.08 D，P=0.001）。斜视（-2.52 D，P=0.014）、无晶状体（-2.45 D，P=0.006）、远距 BCVA（每 0.1 logMAR 下降 0.15 D，P=0.024）和手术并发症（-3.02 D，P=0.001）是危险因素。多变量分析显示，手术时年龄较大（+0.06 D，P=0.012）和手术并发症（-2.52 D，P=0.001）仍有显著意义。
在儿童白内障手术中，手术时年龄较小且合并手术并发症时，近视漂移更大。
