Intraocular pressure in children after congenital heart surgery: A single-center study.
Intraocular pressure in children after congenital heart surgery: A single-center study.
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DOI：
10.4103/apc.apc_41_17
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发表时间：
2017-09
影响因子：
0.7
通讯作者：
Gupta P
中科院分区：
文献类型：
--
作者：
Goyal S;Phillips PH;Corder LA;Robertson MJ;Garcia X;Schmitz ML;Gupta P
不同的心脏生理学对接受心脏手术的儿童的眼内压（IOP）的影响尚不清楚。本研究的目的是确定不同心血管生理和不同血流动力学的儿童心脏手术后的眼压。这是一项前瞻性、观察性研究。接受先天性心脏病手术的≤18岁患者纳入本研究。在心脏手术后3至14天之间通过Icare®眼压计进行IOP测量。估计所有人口统计学、人体测量学和临床数据的汇总统计量。共纳入58名儿童的116只眼。平均和标准差年龄为28.4（45.8）个月。26例患者（45%）存在单心室解剖结构。尽管心率和血压相似，但单心室解剖结构患者的平均IOP显著高于双心室解剖结构患者（18 mm Hg vs. 12 mm Hg，P < 0.001）。基于所进行手术的复杂性，IOP测量值无差异。我们注意到，接受中央分流术（21 mm Hg）、Fontan手术（19 mm Hg）、双向Glenn手术（19 mm Hg）、诺伍德手术（19 mm Hg）或确定性修复术（如法洛四联症修复术（17 mm Hg）和房室管修复术（19 mm Hg））的患者与研究队列中最高的IOP相关。本研究表明，在小儿心脏手术后，IOP随不同的心血管生理而变化。
The impact of varied cardiac physiologies on intraocular pressure (IOP) among children undergoing heart operations is unknown. The aim of this study was to determine the IOP among children with varying cardiovascular physiologies and varying hemodynamics after their heart operation. This was a prospective, observational study. Patients ≤18 years undergoing congenital heart surgery were included in this study. IOP measurement was performed by Icare® tonometer between 3 and 14 days after heart operation. Summary statistics were estimated for all demographic, anthropometric, and clinical data. A total of 116 eyes from 58 children were included. The mean and standard deviation age was 28.4 (45.8) months. Single-ventricle anatomy was present in 26 patients (45%). Despite similar heart rate and blood pressure, the mean IOP among the patients with single-ventricle anatomy was significantly elevated as compared to patients with two-ventricle anatomy (18 mm Hg vs. 12 mm Hg, P < 0.001). There was no difference in IOP measurements based on the complexity of operation performed. We noted that patients undergoing surgical palliation with central shunt (21 mm Hg), Fontan operation (19 mm Hg), bidirectional Glenn operation (19 mm Hg), Norwood operation (19 mm Hg), or definitive repairs such as tetralogy of Fallot repair (17 mm Hg), and atrioventricular canal repair (19 mm Hg) were associated with the highest IOPs in the study cohort. This study demonstrates that IOPs vary with varying cardiovascular physiology after pediatric cardiac surgery.