Akambase Jonas, Barkley Michael, Sharma Richa, Webber Ann, Dai Shuan
Ophthalmology, Queensland Children's Hospital, Brisbane, AUS.
Cureus. 2024 Nov 4;16(11):e73024. doi: 10.7759/cureus.73024. eCollection 2024 Nov.
Purpose To identify and characterize incident cases of strabismus and interocular visual acuity among infants post lensectomy for congenital cataract. Method This was a single-centre retrospective chart review of all children aged less than 12 months who underwent lensectomy from 1st January 2014 to 1st January 2021. Cases were identified from theatre coding and electronic medical records. Cases with strabismus prior to cataract surgery were excluded. Results Seventy-five children (114 aphakic eyes) were included, 36 (48%) had unilateral cataract surgery while 39 (52%) had bilateral. The mean age at the time of cataract surgery was 3.0±2.5 months (range 1 - 10 months). The mean follow-up period was 41.2±22.8 months (range 2 -72 months). Nineteen out of 75 patients (25%) developed strabismus, most of whom (18 cases) had unilateral surgery. Out of the 19 strabismus cases recorded, esotropia was reported in 74% of the cases, followed by exotropia -16%, while esotropia associated with dissociated vertical deviation (DVD) and esotropia associated with inferior oblique each made up 5% of the population. Most children who developed strabismus [17 patients (89.5%)] had lensectomy prior to 6 months of age. A significant difference of 0.65 logMAR was recorded in the interocular visual acuity (IOVA) difference between the strabismic and non-strabismic groups, and the unilateral and bilateral lensectomy groups. Conclusion Strabismus, most commonly esotropia, is common after congenital lensectomy, particularly in those children who underwent unilateral cataract surgery, and in those less than 6 months of age. Monitoring IOVA and strabismus incidence post-cataract surgery is crucial for early intervention and amblyopia prevention.
目的 识别并描述先天性白内障晶状体切除术后婴儿斜视及双眼视力的发病情况及特征。方法 这是一项单中心回顾性病历审查，研究对象为2014年1月1日至2021年1月1日期间接受晶状体切除术的所有12个月以下儿童。病例通过手术编码和电子病历识别。排除白内障手术前已有斜视的病例。结果 纳入75名儿童（114只无晶状体眼），36名（48%）接受单侧白内障手术，39名（52%）接受双侧手术。白内障手术时的平均年龄为3.0±2.5个月（范围1 - 10个月）。平均随访期为41.2±22.8个月（范围2 - 72个月）。75名患者中有19名（25%）发生斜视，其中大多数（18例）接受单侧手术。在记录的19例斜视病例中，74%为内斜视，其次是外斜视 - 16%，而伴有分离性垂直偏斜（DVD）的内斜视和伴有下斜肌的内斜视各占5%。大多数发生斜视的儿童[17例患者（89.5%）]在6个月龄前接受了晶状体切除术。斜视组与非斜视组、单侧与双侧晶状体切除组之间的双眼视力（IOVA）差异记录为0.65 logMAR，有显著差异。结论 斜视，最常见的是内斜视，在先天性晶状体切除术后很常见，尤其是在接受单侧白内障手术的儿童以及6个月以下的儿童中。监测白内障手术后的IOVA和斜视发生率对于早期干预和预防弱视至关重要。
