中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2013年
8期
700-705
,共6页
祝雪宁%喻芳%邢潇英%赵云娥%宫贤惠%李瑾
祝雪寧%喻芳%邢瀟英%趙雲娥%宮賢惠%李瑾
축설저%유방%형소영%조운아%궁현혜%리근
无晶状体,白内障后%晶体,人工%晶体植入,眼内%晶体囊
無晶狀體,白內障後%晶體,人工%晶體植入,眼內%晶體囊
무정상체,백내장후%정체,인공%정체식입,안내%정체낭
Aphakia,postcataract%Lenses,intraocular%Lens implantation,intraocular%Lens capsule,crystalline
目的 比较儿童先天性白内障术后无晶状体眼行Ⅱ期囊袋内与睫状沟人工晶状体(IOL)植入术的临床效果.方法 病例对照研究.观察2005年9月至2011年8月温州医学院附属眼视光医院收治的先天性白内障摘除术后无晶状体眼的患儿,能够坚持随访1年以上且资料完整的病例共44例(60只眼).收集资料包括先天性白内障摘除的年龄、Ⅱ期IOL植入的年龄和眼轴、随访时间、术后并发症、术后最佳矫正视力(BCVA)及屈光状态.视力测量采用标准对数视力表,进行统计分析时转换成Log MAR视力.术中囊袋能够分离且前后囊膜足以包绕支撑IOL的病例行囊袋内IOL植入术,否则行睫状沟IOL植入术.根据IOL植入位置的不同分为囊袋组22例(30只眼)和睫状沟组20例(30只眼).囊袋组及睫状沟组的并发症及合并症比较采用x2检验或Fisher确切概率法；人口资料及手术前后屈光相关资料采用独立t检验或Wilcoxon秩和检验.结果 术后1周及1年的平均等效球镜在囊袋组为1.00D(-2.13 ～3.38 D),0.69 D(-2.25～2.38 D),睫状沟组为0.00 D,(-3.50～3.00 D),-0.50 D,(-3.25 ～2.50 D),两组差异无统计学意义(Z=-1.01,P=0.31;Z=-0.53,P=0.60).末次随访能够配合标准对数视力表检查者,囊袋组BCVA中位数(间距)为0.20(0.05,0.70),睫状沟组为0.20(0.05,0.60),两组间差异无统计学意义(Z=-1.06,P=0.29).两组间眼球震颤发生率囊袋组为33.3％ (10/30),睫状沟组为63.3％ (19/30),两组间相比,差异有统计学意义(x2=5.41,P=0.02),斜视、继发性青光眼、角膜带状变形的发生率在囊袋组为36.7％ (11/30)、3.0％(1/30)、10.0％ (3/30),睫状沟组为23.3％(7/30)、3.0％(1/30)、13.3％(4/30),两组间相比,差异无统计学意义(斜视:x2=1.27,P=0.26;继发性青光眼:x2=0.16,P=0.69;角膜带状变形:P=1.00).结论 儿童先天性白内障摘除术后无晶状体眼Ⅱ期IOL植入术,在1至6年的随访期内,囊袋内植入和睫状沟植入在术后视力和并发症方面无明显差异.
目的 比較兒童先天性白內障術後無晶狀體眼行Ⅱ期囊袋內與睫狀溝人工晶狀體(IOL)植入術的臨床效果.方法 病例對照研究.觀察2005年9月至2011年8月溫州醫學院附屬眼視光醫院收治的先天性白內障摘除術後無晶狀體眼的患兒,能夠堅持隨訪1年以上且資料完整的病例共44例(60隻眼).收集資料包括先天性白內障摘除的年齡、Ⅱ期IOL植入的年齡和眼軸、隨訪時間、術後併髮癥、術後最佳矯正視力(BCVA)及屈光狀態.視力測量採用標準對數視力錶,進行統計分析時轉換成Log MAR視力.術中囊袋能夠分離且前後囊膜足以包繞支撐IOL的病例行囊袋內IOL植入術,否則行睫狀溝IOL植入術.根據IOL植入位置的不同分為囊袋組22例(30隻眼)和睫狀溝組20例(30隻眼).囊袋組及睫狀溝組的併髮癥及閤併癥比較採用x2檢驗或Fisher確切概率法；人口資料及手術前後屈光相關資料採用獨立t檢驗或Wilcoxon秩和檢驗.結果 術後1週及1年的平均等效毬鏡在囊袋組為1.00D(-2.13 ～3.38 D),0.69 D(-2.25～2.38 D),睫狀溝組為0.00 D,(-3.50～3.00 D),-0.50 D,(-3.25 ～2.50 D),兩組差異無統計學意義(Z=-1.01,P=0.31;Z=-0.53,P=0.60).末次隨訪能夠配閤標準對數視力錶檢查者,囊袋組BCVA中位數(間距)為0.20(0.05,0.70),睫狀溝組為0.20(0.05,0.60),兩組間差異無統計學意義(Z=-1.06,P=0.29).兩組間眼毬震顫髮生率囊袋組為33.3％ (10/30),睫狀溝組為63.3％ (19/30),兩組間相比,差異有統計學意義(x2=5.41,P=0.02),斜視、繼髮性青光眼、角膜帶狀變形的髮生率在囊袋組為36.7％ (11/30)、3.0％(1/30)、10.0％ (3/30),睫狀溝組為23.3％(7/30)、3.0％(1/30)、13.3％(4/30),兩組間相比,差異無統計學意義(斜視:x2=1.27,P=0.26;繼髮性青光眼:x2=0.16,P=0.69;角膜帶狀變形:P=1.00).結論 兒童先天性白內障摘除術後無晶狀體眼Ⅱ期IOL植入術,在1至6年的隨訪期內,囊袋內植入和睫狀溝植入在術後視力和併髮癥方麵無明顯差異.
목적 비교인동선천성백내장술후무정상체안행Ⅱ기낭대내여첩상구인공정상체(IOL)식입술적림상효과.방법 병례대조연구.관찰2005년9월지2011년8월온주의학원부속안시광의원수치적선천성백내장적제술후무정상체안적환인,능구견지수방1년이상차자료완정적병례공44례(60지안).수집자료포괄선천성백내장적제적년령、Ⅱ기IOL식입적년령화안축、수방시간、술후병발증、술후최가교정시력(BCVA)급굴광상태.시력측량채용표준대수시력표,진행통계분석시전환성Log MAR시력.술중낭대능구분리차전후낭막족이포요지탱IOL적병례행낭대내IOL식입술,부칙행첩상구IOL식입술.근거IOL식입위치적불동분위낭대조22례(30지안)화첩상구조20례(30지안).낭대조급첩상구조적병발증급합병증비교채용x2검험혹Fisher학절개솔법；인구자료급수술전후굴광상관자료채용독립t검험혹Wilcoxon질화검험.결과 술후1주급1년적평균등효구경재낭대조위1.00D(-2.13 ～3.38 D),0.69 D(-2.25～2.38 D),첩상구조위0.00 D,(-3.50～3.00 D),-0.50 D,(-3.25 ～2.50 D),량조차이무통계학의의(Z=-1.01,P=0.31;Z=-0.53,P=0.60).말차수방능구배합표준대수시력표검사자,낭대조BCVA중위수(간거)위0.20(0.05,0.70),첩상구조위0.20(0.05,0.60),량조간차이무통계학의의(Z=-1.06,P=0.29).량조간안구진전발생솔낭대조위33.3％ (10/30),첩상구조위63.3％ (19/30),량조간상비,차이유통계학의의(x2=5.41,P=0.02),사시、계발성청광안、각막대상변형적발생솔재낭대조위36.7％ (11/30)、3.0％(1/30)、10.0％ (3/30),첩상구조위23.3％(7/30)、3.0％(1/30)、13.3％(4/30),량조간상비,차이무통계학의의(사시:x2=1.27,P=0.26;계발성청광안:x2=0.16,P=0.69;각막대상변형:P=1.00).결론 인동선천성백내장적제술후무정상체안Ⅱ기IOL식입술,재1지6년적수방기내,낭대내식입화첩상구식입재술후시력화병발증방면무명현차이.
Objective To compare the results of secondary in-the-bag intraocular lens (IOL) implantation with secondary sulcus IOL implantation in the eyes which received cataract extraction during early infancy.Methods A case control study.We selected 60 eyes of 44 patients with pediatric aphakia that meet the inclusion criterion in Affiliated Eye Hospital of Wenzhou Medical College from September 2005 to August,2011.Thirty eyes received in-the-bag secondary IOL implantation and were compared with 30 eyes that received secondary sulcus IOL implantation.Data were collected for the ages at cataract extraction and at secondary IOL implantation,the preoperative axial length,the length of follow-up,postoperative complications,postoperative best-corrected visual acuity (BCVA) and refraction.When sufficient capsular opening was possible or capsular support deemed adequate,an IOL was placed within the capsular bag,otherwise the IOL was implanted in the sulcus.The x2 test or Fisher exact test was used to compare complications between the in-the-bag and sulcus groups.The independent-samples t test or Wilcoxon rank sum test was used to compare demographic,preoperative and postoperative refractive relevant data between the in-the-bag and sulcus groups.Results The median of 1-week-postoperative spherical equivalent clustered 1.00 D (range,-2.13 to 3.38 D) for in-the-bag group and 0.69 D (range,-2.25 to 2.38 D) for the sulcus group (Z =-1.01,P =0.31).The median of 1-year-postoperative spherical equivalent clustered 0.00 D (range,-3.50 to 3.00 D) for in-the-bag and-0.50 D (range,-3.25 to 2.50 D) for the sulcus (Z =-0.53,P =0.60).The last follow-up BCVA was available in 23 of 30 eyes in the in-the-bag group and 22 of 30 eyes in the sulcus group.The median of visual outcome clustered around 0.20 D (range,0.05 to 0.70 D) for in-the-bag and 0.20 D (range,0.05 to 0.60 D) for the sulcus (Z =-1.06,P =0.29).The rate of nystagmus was significantly greater in the sulcus group (63.3％) than in the in-the-bag group(33.3％) (x2 =5.41,P =0.02).The incidence of strabismus,glaucoma and corneal calcific band keratopathy in the in-the-bag group were 36.7％ (11/30),3.0％ (1/30) and 10.0％ (3/30) ;23.3％ (7/30),3.0％ (1/30) and 13.3％ (4/30) in the sulcus group,respectively.There were no significant differences between the two groups (Strabismus:x2 =1.27,P =0.26; Glaucoma:x2 =0.16,P =0.69 ; corneal calcific band keratopathy:P =1.00).Conclusions For children who have been aphakic due to receiving cataract extraction during their early infancy,there was no significant difference in both postoperative complications and visual acuity between the secondary in-the-bag IOL implantation and secondary sulcus IOL implantation during 1 year to 6 years follow-up time after the implantation surgery.
