摘要
目的:评估双侧无晶状体儿童采用改良切口Ⅱ期睫状沟人工晶状体(IOL)植入术的屈光度误差及安全性。方法:回顾性分析2020/2021接受改良切口Ⅱ期睫状沟折叠式IOL植入术的12例24眼双侧无晶状体儿童资料。分析术中、术后1 d及术后1 mo切口相关并发症的发生情况,记录最佳矫正视力(BCVA),眼轴长度(AL),水平角膜直径(WTW),以及术前预留屈光度(PRD)和实际等效球镜屈光度(AESD)的屈光结果。将患者按年龄(≤7岁和>7岁)、AL(<23和≥23 mm)和WTW(≤11.5和>11.5 mm)分为两组,比较根据测量结果预测的AESD和PRD之间屈光度误差。结果:在所有患儿中,男孩9例(75%),女孩3例(25%),其中2例(17%)为前囊下白内障,4例(33%)为后极性白内障,6例(50%)为核性白内障。白内障摘除时的平均年龄为6.4±1.61(3.4-8.9)mo,白内障摘除至Ⅱ期IOL植入术的平均时间间隔为6.8±1.82(4.4-11.5)a。术前平均BCVA为0.49±0.33(1.0-0.1)LogMAR,术后平均BCVA为0.38±0.32(1.0-0.0)LogMAR。平均AL为23.56±1.96(19.00-26.38)mm,平均WTW为11.5±0.92(9.3-13.9)mm,平均PRD为1.57±0.60(0.73-2.77)D,平均AESD为0.57±0.55(-0.50-1.75)D,AESD与PRD的平均差值为-0.99±0.52(-2.22-0.32)D。按年龄、AL、WTW分组的AESD、PRD差异无统计学意义(P=0.59、0.56、0.53)。结论:无晶状体儿童采用改良切口Ⅱ期睫状沟IOL植入安全可行。在睫状沟植入IOL时,需要从公式选择的IOL度数中减去约1 D。年龄、AL和WTW对差异无显著影响。
AIM:To evaluate the diopter errors and safety of secondary intraocular lens(IOL)implantation in the ciliary sulcus using a modified incision procedure in children with bilateral aphakia.METHODS:The data of 12 children(24 eyes)with bilateral aphakia who had undergone secondary foldable IOL implantation in the ciliary sulcus using a modified incision procedure from 2020 to 2021 were retrospectively reviewed.Incision-related complications were analyzed intraoperatively and at 1 d and 1 mo postoperatively.Best-corrected visual acuity(BCVA),axial length(AL),white-to-white(WTW),and refractive outcomes in terms of preoperative reserved diopters(PRD)and actual equivalent spherical diopters(AESD).The patients were divided into two groups by age(≤7 and>7 a),AL(<23 and≥23 mm)and WTW(≤11.5 and>11.5mm),and the diopter errors between their AESD and PRD predicted based on the measurement results were compared.RESULTS:The patients comprised 9(75%)boys and 3(25%)girls.Two(17%)patients had anterior subcapsular cataracts,4(33%)had posterior polar cataracts,and 6(50%)had nuclear cataracts.The mean age at cataract extraction was 6.4±1.61(3.4-8.9)mo.The mean interval between cataract extraction and secondary IOL implantation was 6.8±1.82(4.4-11.5)a.The mean preoperative BCVA was 0.49±0.33(1.0-0.1)LogMAR.The mean postoperative BCVA was 0.38±0.32(1.0-0.0)LogMAR.The mean AL was 23.56±1.96(19.00-26.38)mm,and the mean WTW was 11.5±0.92(9.3-13.9)mm.The mean PRD was 1.57±0.60(0.73-2.77)D,the mean AESD was 0.57±0.55(-0.50 to 1.75)D,and the mean difference between the AESD and PRD was-0.99±0.52(-2.22 to 0.32)D.The differences in the AESD and PRD between the groups according to age,AL and WTW were not statistically significant(P=0.59,0.56,and 0.53,respectively).CONCLUSION:IOL implantation in the ciliary sulcus after a modified incision is safe and feasible for children with aphakia.It is necessary to subtract approximately 1 D of IOL power from the formula-selected power when implanting an IOL in the ciliary sulcus.Age,AL,and WTW do not significantly affect the difference.
作者
马子程
朱思泉
Ma Zicheng;Zhu Siquan(Department of Ophthalmology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《国际眼科杂志》
CAS
2024年第8期1179-1185,共7页
International Eye Science
基金
国家自然科学基金(No.52273134)。
关键词
先天性白内障
Ⅱ期人工晶状体植入术
改良切口
屈光度误差
congenital cataract
secondary intraocular lens implantation
modified incision
diopter errors
作者简介
马子程,毕业于首都医科大学,硕士,主治医师,教学秘书,研究方向:白内障;通讯作者:朱思泉,毕业于首都医科大学,博士,主任医师,教授,研究方向:白内障、屈光.siquanzhu@qq.com。
