Age at the time of cataract surgery and relative risk for aphakic glaucoma in nontraumatic infantile cataract
Age at the time of cataract surgery and relative risk for aphakic glaucoma in nontraumatic infantile cataract
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DOI：
10.1016/j.jaapos.2008.10.020
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发表时间：
2009-04-01
期刊：
影响因子：
1.6
通讯作者：
Al-Dahmesh, Saad
中科院分区：
文献类型：
--
作者：
Khan, Arif O.;Al-Dahmesh, Saad
目的：报告无小角膜的非外伤性婴幼儿白内障在10个月龄前接受手术的婴儿中，无晶状体性青光眼的相对风险与手术年龄的关系。
方法：这是一个机构回顾性病例系列研究（1985年1月至2003年2月），研究对象是10个月龄前因非外伤性婴幼儿白内障接受白内障手术且未植入人工晶状体的儿童。术后随访少于5年、有小角膜、持续性胎儿血管结构和/或其他明显眼前节异常的患者被排除。
结果：所有病例的手术方式均为晶状体抽吸、后囊切开以及采用眼前节小切口技术的前段玻璃体切除术。在210只眼（121例患者）中，55只眼（26.2%；31例患者[25.6%]）发生了无晶状体性青光眼。手术时年龄与后期无晶状体性青光眼相对风险的关系是：在0 - 1个月龄时为1.85（95%置信区间，0.88 - 3.86），在3 - 4个月龄时降至最低点（0.22[95%置信区间，0.05 - 0.96]），然后再次升高，在5 - 6个月龄时达到峰值3.17（95%置信区间，1.1 - 9.11）。
结论：在我们的队列中，后期发生无晶状体性青光眼相对风险最低的是在3 - 4个月龄时进行手术，其95%置信区间始终小于1.0。由于置信区间重叠，进一步的结论受到限制。然而，由于弱视问题，我们不建议将先天性白内障手术推迟到出生后4周以后。（《美国小儿眼科与斜视学会杂志》2009年；13：166 - 169）
PURPOSE To report the relative risk for aphakic glaucoma as a function of age at surgery in infants who underwent cataract surgery before 10 months of age for nontraumatic infantile cataract without microcornea.METHODS This was an institutional retrospective case series (January 1985 to February 2003) of children who underwent cataract surgery without intraocular lens implantation for nontraumatic infantile cataract before 10 months of age. Patients with less than 5 years' postsurgical follow-up, microcornea, persistent fetal vasculature, and/or other significant anterior segment abnormality were excluded.RESULTS The surgical procedure in all cases was lens aspiration, posterior capsulotomy, and anterior vitrectomy with anterior small-incision techniques. Of 210 eyes (121 patients), 55 eyes (26.2%; 31 patients [25.6%]) developed aphakic glaucoma. Relative risk for later aphakic glaucoma as a function of age at the time of surgery decreased from 1.85 (95% CI, 0.88-3.86) at 0-1 months of age to a nadir at 3-4 months of age (0.22 [95% CI, 0.05-0.96]) and then increased again to peak at 3.17 (95% CI, 1.1-9.11) at 5-6 months of age.CONCLUSIONS The lowest relative risk for later aphakic glaucoma in our cohort was for surgery performed at 3-4 months of age, for which the 95% CI remained less than 1.0. Further conclusions are limited by overlapping confidence intervals. However, because of amblyopia issues, we do not recommend delaying congenital cataract surgery beyond 4 weeks of life. (J AAPOS 2009;13:166-169)