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Childhood Lensectomy Is Associated with Static and Dynamic Reduction in Schlemm Canal Size: A Biomechanical Hypothesis of Glaucoma after Lensectomy.
Ophthalmology ( IF 13.1 ) Pub Date : 2018-08-30 , DOI: 10.1016/j.ophtha.2018.08.031
Moritz C Daniel 1 , Adam M Dubis 2 , Maria Theodorou 3 , Ana Quartilho 4 , Gillian Adams 5 , John Brookes 6 , Maria Papadopoulos 6 , Peng T Khaw 7 , Annegret H Dahlmann-Noor 3
Affiliation  

PURPOSE To compare Schlemm canal (SC) and trabecular meshwork (TM) in children with healthy eyes and those with and without glaucoma after lensectomy. DESIGN Cross-sectional observational study. PARTICIPANTS Fifty children 4 to 16 years of age with healthy eyes and 48 children who underwent lensectomy (124 healthy and 72 postlensectomy eyes). METHODS Anterior segment (AS) OCT (Tomey SS-1000 CASIA; Tomey, Nagoya, Japan) of the nasal iridocorneal angle at 2 levels of accommodative effort (2.5 diopters [D] and 15 D). For each parameter and state of accommodation, a random effects model was fitted to estimate differences between healthy eyes and eyes with history of lensectomy. MAIN OUTCOME MEASURES Dimensions of SC and TM and conventional AS OCT iridocorneal angle measurements. RESULTS The horizontal diameter of SC and its cross-sectional area (CSA) are significantly smaller in eyes that have undergone lensectomy versus healthy eyes. Accommodative effort increases SC size in healthy eyes, but not in eyes that have undergone lensectomy. CONCLUSIONS Lensectomy is associated with a reduction in SC size and a loss of physiologic SC dilatation during accommodative effort, which may reflect a reduction in outflow facility and may contribute to the development of glaucoma after lensectomy.

中文翻译:

儿童晶状体切除术与Schlemm根管大小的静态和动态减少有关:晶状体切除术后青光眼的生物力学假说。

目的比较健康眼睛和晶状体切除术后有无青光眼的儿童的Schlemm管(SC)和小梁网(TM)。设计横断面观察研究。参与者50名年龄在4至16岁之间且眼睛健康的儿童和48名接受了晶状体摘除术的儿童(124眼健康的和72眼摘除术后的眼睛)。方法鼻虹膜角膜角的前节(AS)OCT(Tomey SS-1000 CASIA; Tomey,日本名古屋)在2个水平的调节力下(2.5屈光度[D]和15 D)。对于每个参数和调节状态,均采用随机效应模型来估计健康眼睛和有晶状体摘除术史的眼睛之间的差异。主要观察指标SC和TM的尺寸以及常规的AS OCT虹膜角膜角度测量。结果与健康的眼睛相比,接受晶状体摘除术的眼睛的SC的水平直径及其横截面积(CSA)明显较小。适应性努力会增加健康眼睛的SC大小,但不会增加接受晶状体摘除术的眼睛的SC大小。结论晶状体摘除术与适应性努力期间SC尺寸的减小和生理性SC扩张的丧失有关,这可能反映出流出设施的减少,并可能有助于晶状体摘除术后青光眼的发展。
更新日期:2018-08-30
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