A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life
A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life
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DOI：
10.1067/mpa.2001.111015
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发表时间：
2001-04-01
期刊：
影响因子：
1.6
通讯作者：
Fawcett, SL
中科院分区：
文献类型：
--
作者：
Lambert, SR;Lynn, M;Fawcett, SL
目的：婴儿期单侧白内障摘除术后无晶状体眼的矫正方法存在争议。一些权威人士主张用人工晶状体（IOL）矫正，而另一些则主张用角膜接触镜（CL）矫正。我们在5个临床中心比较了接受这两种矫正方式的年龄匹配儿童的光栅视力、眼位和再次手术结果。
方法：本研究纳入了1997年或1998年出生的25名患有单侧致密先天性白内障的婴儿，他们在白内障手术时分别接受了（IOL组，n = 12）或未接受（CL组，n = 13）一期人工晶状体植入。所有患者都接受了半时间遮盖疗法。1999年7月，对他们的光栅视力、眼位和再次手术率进行了评估。
结果：IOL组患眼的平均光栅视力（LogMAR）为0.70±0.32，CL组为0.87±0.31（P = 0.19）。IOL组光栅视力的平均双眼差异为0.26±0.30，CL组为0.50±0.28（P = 0.048）。IOL组斜视（>10 PD）的发生率为75%，而CL组为92%（P = 0.24）。IOL组再次手术的发生率为83%，而CL组为23%（P = 0.003）。
结论：我们的初步数据表明，在单侧先天性白内障手术后一期植入人工晶状体矫正无晶状体眼可改善视力结果，但需要再次手术的并发症发生率较高。一项随机临床试验——婴儿无晶状体眼治疗研究已计划开展，以进一步研究婴儿期单侧白内障摘除术后无晶状体眼的最佳治疗方法。
Purpose: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. Methods:Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. Results: The mean grating visual acuity (LogMAR) for the affected eye was 0.70 +/- 0.32 for the IOL group and 0.87 +/- 0.31 for the CL group (P=.19). The mean interocular difference in grating visual acuity was 0.26 +/- 0.30 for the IOL group and 0.50 +/- 0.28 for the CL group (P=.048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P=.24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P=.003), Conclusions: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.