持续胎儿血管的手术参数和预后因素：来自回顾性队列研究的见解。

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-01-15 DOI:10.1007/s40123-024-01088-6

Fatima AlGhazal, Valmore A Semidey, Marcos J Rubio-Caso, Sulaiman M AlSulaiman, Gorka Sesma

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引用次数: 0

摘要

持续性胎儿血管（PFV）是一种先天性异常，与重大手术挑战相关，包括术后视网膜脱离（RD）的高风险。本研究旨在评估手术入路和轴向长度（AL）对儿童PFV治疗中RD风险和视力结果的影响。方法：回顾性队列研究，涉及2014年至2022年期间接受白内障手术治疗的74例患者的76只眼。根据术后RD状态对患者进行分类（有RD 14例，无RD 62例）。分析了关键预测因素，包括手术入路（角膜vs皱襞）、AL和手术年龄。主要结局为RD发生率和最终最佳矫正视力（BCVA）。结果：与皱襞部入路相比，角膜入路发生RD的风险显著降低，多因素优势比为0.08 （95% CI 0.01-0.6, P = 0.011）。较短的AL增加了RD的风险（中位数17 vs 20 mm， P = 0.002）。结论：角膜手术入路和较长的AL与PFV白内障手术中较低的RD风险相关。早期干预和全面的术前评估AL和睫状突是获得最佳结果的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgical Parameters and Prognostic Factors in Persistent Fetal Vasculature: Insights from a Retrospective Cohort Study.

Introduction: Persistent fetal vasculature (PFV) is a congenital anomaly associated with significant surgical challenges, including a high risk of postoperative retinal detachment (RD). This study aimed to evaluate the impact of surgical approach and axial length (AL) on RD risk and visual outcomes in pediatric PFV management.

Methods: A retrospective cohort study was conducted involving 76 eyes of 74 patients who underwent cataract surgery for PFV between 2014 and 2022. Patients were categorized by RD status postoperatively (14 with RD, 62 without RD). Key predictors, including surgical approach (corneal vs. pars plicata), AL, and age at surgery, were analyzed. The primary outcomes were RD incidence and final best-corrected visual acuity (BCVA).

Results: Compared to the pars plicata approach, the corneal approach was associated with a significantly lower risk of RD, as indicated by a multivariate odds ratio of 0.08 (95% CI 0.01-0.6, P = 0.011). A shorter AL increased the risk of RD (median 17 vs. 20 mm, P = 0.002). The RD group showed poorer visual outcomes (P < 0.001), with a 71% loss of light perception. Surgery before 3 months improved outcomes, regardless of RD. Visible ciliary processes were strongly correlated with RD (P < 0.001).

Conclusions: Corneal surgical approach and longer AL are associated with a lower RD risk in PFV cataract surgery. Early intervention and thorough preoperative assessment of the AL and ciliary processes are crucial for optimal outcomes.

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. 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