Shi Jingyi, Wang Dandan, Xie Yang, Lu Ziyi, Zhang Ruiwen, Dou Renhui, Xie Mengjuan, Chen Ruru, Zhao Yun-E
Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China.
Ophthalmic Res. 2024;67(1):625-634. doi: 10.1159/000541947. Epub 2024 Oct 10.
This study aimed to examine the impact of cataract surgery on the corneal endothelium and central corneal thickness (CCT) in pediatric patients, and to identify the factors associated with corneal alterations.
This retrospective study included consecutive children undergoing bilateral or unilateral cataract surgery and intraocular lens implantation at the Eye Hospital of Wenzhou Medical University, with or without posterior capsulorhexis and anterior vitrectomy, and an age-matched normal control group. This study aimed to assess whether changes in corneal parameters, including CCT, corneal endothelial cell density (CD), average cell area (AVE), standard deviation of size (SD), coefficient of variation (CV), percentage of hexagonal cells (6A) before and after surgery, and endothelial cell loss (ECL) differed among the bilateral cataract, unilateral cataract, and control groups. Furthermore, the potential effects of anterior vitrectomy, axial length, preoperative anterior chamber depth, surgical duration, horizontal corneal diameter, intraoperative pupil diameter (PD), and the number of corneal sutures on corneal endothelial parameters and CCT were investigated.
A total of 107 eyes from 107 children were included in the study. In the bilateral cataract group, CD significantly decreased, AVE and CCT significantly increased, and ECL was significantly higher than in the control group. The unilateral cataract group also exhibited a significant increase in CCT. Additionally, the number of corneal sutures was negatively correlated with CD, and PD was negatively correlated with CV in the unilateral cataract group.
Cataract surgery in pediatric patients results in increased CCT, reduced CD, and morphological changes in corneal cells. A greater number of corneal sutures and a smaller PD increased the risk of CD reduction and elevated CV in the unilateral cataract group, underscoring the need for ophthalmologists to minimize corneal damage in these children.
本研究旨在探讨白内障手术对小儿患者角膜内皮及中央角膜厚度（CCT）的影响，并确定与角膜改变相关的因素。
这项回顾性研究纳入了在温州医科大学附属眼视光医院连续接受双侧或单侧白内障手术及人工晶状体植入的儿童，手术包括或不包括后囊撕开和前部玻璃体切割，同时纳入了年龄匹配的正常对照组。本研究旨在评估双侧白内障组、单侧白内障组和对照组手术前后角膜参数的变化，这些参数包括CCT、角膜内皮细胞密度（CD）、平均细胞面积（AVE）、大小标准差（SD）、变异系数（CV）、六边形细胞百分比（6A）以及内皮细胞丢失（ECL）。此外，还研究了前部玻璃体切割、眼轴长度、术前前房深度、手术时长、角膜水平直径、术中瞳孔直径（PD）以及角膜缝线数量对角膜内皮参数和CCT的潜在影响。
本研究共纳入107名儿童的107只眼。双侧白内障组中，CD显著降低，AVE和CCT显著增加，且ECL显著高于对照组。单侧白内障组的CCT也显著增加。此外，在单侧白内障组中，角膜缝线数量与CD呈负相关，PD与CV呈负相关。
小儿白内障手术会导致CCT增加、CD降低以及角膜细胞形态改变。在单侧白内障组中，更多的角膜缝线和更小的PD增加了CD降低和CV升高的风险，这强调了眼科医生需要尽量减少对这些儿童角膜的损伤。
