Randomised clinical trial of lensectomy versus lens aspiration and primary capsulotomy for children with bilateral cataract in south India
Randomised clinical trial of lensectomy versus lens aspiration and primary capsulotomy for children with bilateral cataract in south India
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DOI：
10.1136/bjo.83.5.524
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发表时间：
1999-05-01
影响因子：
4.1
通讯作者：
Foster, A
中科院分区：
文献类型：
--
作者：
Eckstein, M;Vijayalakshmi, P;Foster, A
主要目的是确定哪种手术技术能为印度南部患有双侧对称性白内障的婴幼儿提供最佳的长期视力结果。次要目的是评估并发症和进一步手术干预的需要。方法进行随机对照临床试验。65名10岁以下的儿童双侧白内障有一只眼睛的晶状体切除术和其他的吸引与初级capsulotomy.Results-56名儿童（86%）的平均年龄为53个月的手术后3年进行了审查。57.1%的患者双眼视力为6/18或更好，94.6%的患者双眼视力为6/60或更好。在第三年随访时，接受抽吸或晶状体切除术的配对眼睛之间的视力没有差异（p=0.57）。抽吸眼更可能需要二次手术恢复视力比晶状体切除眼（66.1%比1.8%）。结论抽吸与初级囊切开术提供了一个可接受的视觉结果，在这一部分的印度提供了良好的后续管理胶囊混浊。如果由于随访依从性差而无法进行二次干预，则晶状体切除术可能会提供更好的长期视力康复，前提是晶状体切除术设备有良好的维护和技术支持。
Aims-The primary objective was to determine which surgical technique gave the best long term visual outcome for infants and young children with bilateral symmetrical cataract in south India. Secondary objectives were to assess complications and the need for further surgical intervention.Methods-A randomised controlled clinical trial was undertaken. 65 children under 10 years old with bilateral cataract had one eye treated by lensectomy and the other by aspiration with primary capsulotomy.Results-56 children (86%) with a mean age at surgery of 53 months were reviewed 3 years after surgery. The overall binocular acuity was 6/18 or better in 57.1% and 6/60 or better in 94.6%. There was no difference in visual acuity between the matched pairs of eyes undergoing aspiration or lensectomy at the third year of follow up (p=0.57). Aspiration eyes were more likely to require a secondary procedure to restore vision than lensectomy eyes (66.1% v 1.8%).Conclusion-Aspiration with primary capsulotomy gives an acceptable visual outcome in this part of India providing that there is good follow up to manage capsule opacification. If secondary intervention is not possible owing to poor compliance with follow up, then lensectomy is likely to give better long term visual rehabilitation providing there is good maintenance and technical support for the lensectomy equipment.