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Long-term outcome of primary intraocular lens implantation in bilateral congenital cataract in infants with a median age of 35 days at surgery: a case series
BMJ Open Ophthalmology ( IF 2.0 ) Pub Date : 2021-09-01 , DOI: 10.1136/bmjophth-2021-000836
Mari Kathrine Sand 1, 2 , Symira Cholidis 1 , Kjartan Rimstad 3 , Elise Dees Krekling 4 , Olav Kristianslund 1, 2 , Liv Drolsum 1, 2
Affiliation  

Objective To evaluate the long-term visual outcome and safety after bilateral cataract surgery with primary intraocular lens (IOL) implantation in infants with visually significant cataract at birth operated before 12 weeks of age. Methods and analysis Medical records of infants with congenital cataract who had bilateral surgery with primary IOL implantation before 12 weeks of age at Oslo University Hospital between 2007 and 2016 were retrospectively reviewed. Fifteen infants (30 eyes) were enrolled for a prospective study examination in 2017. Corrected distance visual acuity (CDVA) and intraocular pressure (IOP) were assessed. Visual axis opacification (VAO) was defined as opacification on the anterior or posterior surface of the IOL, capsular phimosis or fibrinous membrane. Secondary glaucoma was evaluated according to international guidelines. Results Median age at the time of primary surgery was 35 days (range, 15 to 70 days). There were no serious intraoperative complications, and all eyes had the IOL implanted in the capsular bag. After a median follow-up of 6.1 years (range, 1.5 to 10.2 years), the CDVA was 0.5 logMAR (range, 1.2 to 0.04). All eyes had surgery for VAO and the median number of surgical procedures was 2.0 (range, 1 to 5). The cumulative incidence of secondary glaucoma was 10% after 5 years of follow-up. Conclusion Primary IOL implantation before 12 weeks of age gave a satisfactory visual outcome, and the incidence of secondary glaucoma was similar to that reported after primary IOL implantation in older infants. However, the risk of VAO was high. Data are available upon reasonable request.

中文翻译:

双侧先天性白内障原发性人工晶状体植入术中位年龄为 35 天的婴儿的长期结果:病例系列

目的评价12周龄前出生时有明显白内障的婴儿双侧白内障植入人工晶状体(IOL)术后远期视力预后和安全性。方法与分析 回顾性分析2007-2016年奥斯陆大学医院12周龄前先天性白内障患儿双侧手术植入人工晶状体的病历。2017 年,15 名婴儿(30 只眼)参加了一项前瞻性研究检查。评估了矫正远视力(CDVA)和眼压(IOP)。视轴混浊(VAO)被定义为IOL、包茎或纤维蛋白膜前表面或后表面的混浊。根据国际指南评估继发性青光眼。结果初次手术时的中位年龄为 35 天(范围为 15 至 70 天)。术中无严重并发症,所有眼均在囊袋内植入人工晶状体。中位随访 6.1 年(范围,1.5 至 10.2 年)后,CDVA 为 0.5 logMAR(范围,1.2 至 0.04)。所有眼睛都接受了 VAO 手术,手术次数的中位数为 2.0(范围,1 至 5)。随访5年后,继发性青光眼的累积发生率为10%。结论 12周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。15 至 70 天)。术中无严重并发症,所有眼均在囊袋内植入人工晶状体。中位随访 6.1 年(范围,1.5 至 10.2 年)后,CDVA 为 0.5 logMAR(范围,1.2 至 0.04)。所有眼睛都接受了 VAO 手术,手术次数的中位数为 2.0(范围,1 至 5)。随访5年后,继发性青光眼的累积发生率为10%。结论 12周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。15 至 70 天)。术中无严重并发症,所有眼均在囊袋内植入人工晶状体。中位随访 6.1 年(范围,1.5 至 10.2 年)后,CDVA 为 0.5 logMAR(范围,1.2 至 0.04)。所有眼睛都接受了 VAO 手术,手术次数的中位数为 2.0(范围,1 至 5)。随访5年后,继发性青光眼的累积发生率为10%。结论 12周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。1 年(范围,1.5 至 10.2 年),CDVA 为 0.5 logMAR(范围,1.2 至 0.04)。所有眼睛都接受了 VAO 手术,手术次数的中位数为 2.0(范围,1 至 5)。随访5年后,继发性青光眼的累积发生率为10%。结论 12周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。1 年(范围,1.5 至 10.2 年),CDVA 为 0.5 logMAR(范围,1.2 至 0.04)。所有眼睛都接受了 VAO 手术,手术次数的中位数为 2.0(范围,1 至 5)。随访5年后,继发性青光眼的累积发生率为10%。结论 12周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。结论 12周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。结论 12 周龄前初次植入人工晶状体获得了令人满意的视力结果,继发性青光眼的发生率与较大婴儿初次植入人工晶状体后报道的发生率相似。然而,VAO 的风险很高。可根据合理要求提供数据。
更新日期:2021-09-30
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