Al-Lozi Amal M, McFadyen James, Shue Ann, Lambert Scott R
Department of Ophthalmology, Stanford Health Care, Palo Alto, California.
Gloucestershire Royal Hospital, Gloucester, England.
J AAPOS. 2025 Aug 7:104279. doi: 10.1016/j.jaapos.2025.104279.
Visual axis opacities are one of the most common complications following infantile cataract surgery. To date, most studies have focused on lens reproliferation and pupillary membranes rather than capsular phimosis. We evaluated risk factors for capsular phimosis after lensectomies in infants.
A retrospective chart and video review of patients seen at a single institution over a period of 4 years was performed. Exclusion criteria were follow-up of <7 months and poor video quality. Two independent examiners, masked to patient outcomes, calculated capsulotomy diameters from video stills. To analyze risk factors for capsular phimosis, the χ test was used for categorical variables; the independent t test for continuous variables. For bilateral cases, one eye was randomly included in capsulotomy analysis.
A total of 20 eyes of 12 patients, aged 1.7 months (IQR, 1.25; range, 0.6-3.2) at time of surgery, were reviewed. Median follow-up was 1.7 years (IQR, 2.39; range, 0.5-3.9). Capsular phimosis developed in 7 eyes (35%) and required surgical intervention in 5 eyes (25%) a median of 2.3 months (IQR 1.49; range, 1.2-5.1) after primary surgery. Male sex (P = 0.03) and smaller anterior horizontal (4.31 vs 5.78 mm [P = 0.0039]), anterior vertical (4.67 vs 5.59 [P = 0.0131]), and posterior vertical (4.10 vs 5.08 mm [P = 0.00074]) capsulotomy diameters increased risk of phimosis.
In our study cohort, capsular phimosis was a common complication following a lensectomy in infants. Smaller anterior and posterior capsulotomy diameters increase risk of capsular phimosis.
视轴混浊是婴幼儿白内障手术后最常见的并发症之一。迄今为止，大多数研究都集中在晶状体再增殖和瞳孔膜，而非晶状体囊膜缩窄。我们评估了婴儿晶状体切除术后晶状体囊膜缩窄的危险因素。
对一家机构4年间诊治的患者进行回顾性病历及视频分析。排除标准为随访时间小于7个月及视频质量差。两名独立检查者在不知患者预后的情况下，根据视频静态图像计算晶状体囊切开术直径。为分析晶状体囊膜缩窄的危险因素，分类变量采用χ检验；连续变量采用独立t检验。对于双眼病例，随机选取一只眼纳入晶状体囊切开术分析。
共纳入12例患者的20只眼，手术时年龄为1.7个月（四分位间距，1.25；范围，0.6 - 3.2）。中位随访时间为1.7年（四分位间距，2.39；范围，0.5 - 3.9）。7只眼（35%）发生晶状体囊膜缩窄，其中5只眼（25%）在初次手术后中位2.3个月（四分位间距1.49；范围，1.2 - 5.1）需要手术干预。男性（P = 0.03）以及较小的前水平（4.31对5.78 mm [P = 0.0039]）、前垂直（4.67对5.59 [P = 0.0131]）和后垂直（4.10对5.08 mm [P = 0.00074]）晶状体囊切开术直径增加了晶状体囊膜缩窄的风险。
在我们的研究队列中，晶状体囊膜缩窄是婴儿晶状体切除术后的常见并发症。较小的前后晶状体囊切开术直径增加了晶状体囊膜缩窄的风险。
