{"title":"刚性角膜镜片对白内障术后单侧无晶状体婴儿视力康复的影响：纵向病例系列。","authors":"Honggai Yan, Li Li, Tianwei Liang","doi":"10.1097/ICL.0000000000001173","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the safety of rigid corneal lenses in children with unilateral aphakia after cataract surgery and observed the visual rehabilitation longitudinally.</p><p><strong>Methods: </strong>This retrospective cohort study performed a 3-year follow-up of 21 infants (age 5.9±3.3 months) with unilateral congenital cataracts who started wearing rigid corneal contact lenses after cataract surgery. The basic presurgical patient information included chief complaint, intraocular pressure (IOP), axial length, corneal width, anterior segment, and fundus examination. The postsurgical visual acuity, IOP, and anterior segment were examined during regular postoperative follow-up visits. Keratometry was performed when contact lenses had to be changed.</p><p><strong>Results: </strong>Of the 21 patients, 15 were male and 6 were female. Before surgery, the affected and nonaffected eyes had similar IOP (9.5±3.5 vs. 9.2±2.8 mm Hg; P =0.502) and axial length (19.2±1.5 vs. 19.4±0.96; P =0.333). The corneal diameter in the affected eyes was smaller than in the nonaffected eyes (10.2±0.7 vs. 10.6±0.6 mm; P =0.002). After surgery, the logarithm of the minimum angle of resolution vision of the affected eyes improved gradually, showing values of 1.12±0.28, 0.78±0.37, and 0.62±0.38 at 1, 2, and 3 years after surgery, respectively. The respective values in the unaffected eyes were 0.58±0.14, 0.40±0.13, and 0.33±0.16. The mean keratometric astigmatism and keratometry 1 and 3 years after surgery were statistically similar (2.09±1.21 vs. 1.73±1.16 D, P =0.272; 44.82±3.15 vs. 44.39±2.75 D, P =0.324, respectively). No serious complications occurred during the follow-up.</p><p><strong>Conclusion: </strong>The rigid corneal lens is well tolerated and safe in aphakic eyes and can effectively improve children's visual acuity after unilateral cataract surgery. For patients able to receive rigid corneal lenses, intraocular lens implantation can be delayed until after the age of three.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"227-231"},"PeriodicalIF":2.1000,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Rigid Corneal Lenses for Visual Rehabilitation in Infants With Unilateral Aphakia After Cataract Surgery: A Longitudinal Case Series.\",\"authors\":\"Honggai Yan, Li Li, Tianwei Liang\",\"doi\":\"10.1097/ICL.0000000000001173\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study investigated the safety of rigid corneal lenses in children with unilateral aphakia after cataract surgery and observed the visual rehabilitation longitudinally.</p><p><strong>Methods: </strong>This retrospective cohort study performed a 3-year follow-up of 21 infants (age 5.9±3.3 months) with unilateral congenital cataracts who started wearing rigid corneal contact lenses after cataract surgery. The basic presurgical patient information included chief complaint, intraocular pressure (IOP), axial length, corneal width, anterior segment, and fundus examination. The postsurgical visual acuity, IOP, and anterior segment were examined during regular postoperative follow-up visits. Keratometry was performed when contact lenses had to be changed.</p><p><strong>Results: </strong>Of the 21 patients, 15 were male and 6 were female. Before surgery, the affected and nonaffected eyes had similar IOP (9.5±3.5 vs. 9.2±2.8 mm Hg; P =0.502) and axial length (19.2±1.5 vs. 19.4±0.96; P =0.333). The corneal diameter in the affected eyes was smaller than in the nonaffected eyes (10.2±0.7 vs. 10.6±0.6 mm; P =0.002). After surgery, the logarithm of the minimum angle of resolution vision of the affected eyes improved gradually, showing values of 1.12±0.28, 0.78±0.37, and 0.62±0.38 at 1, 2, and 3 years after surgery, respectively. The respective values in the unaffected eyes were 0.58±0.14, 0.40±0.13, and 0.33±0.16. The mean keratometric astigmatism and keratometry 1 and 3 years after surgery were statistically similar (2.09±1.21 vs. 1.73±1.16 D, P =0.272; 44.82±3.15 vs. 44.39±2.75 D, P =0.324, respectively). No serious complications occurred during the follow-up.</p><p><strong>Conclusion: </strong>The rigid corneal lens is well tolerated and safe in aphakic eyes and can effectively improve children's visual acuity after unilateral cataract surgery. For patients able to receive rigid corneal lenses, intraocular lens implantation can be delayed until after the age of three.</p>\",\"PeriodicalId\":50457,\"journal\":{\"name\":\"Eye & Contact Lens-Science and Clinical Practice\",\"volume\":\" \",\"pages\":\"227-231\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-02-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Eye & Contact Lens-Science and Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/ICL.0000000000001173\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eye & Contact Lens-Science and Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ICL.0000000000001173","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨单侧无晶状体儿童白内障术后使用硬质角膜镜片的安全性，并对其视力恢复情况进行纵向观察。方法：本回顾性队列研究对21例单侧先天性白内障患儿（年龄5.9±3.3个月）进行了为期3年的随访，这些患儿在白内障手术后开始佩戴硬性角膜接触镜。术前患者的基本信息包括主诉、眼压（IOP）、眼轴长度、角膜宽度、前段和眼底检查。术后定期随访，检查术后视力、IOP、前段。当必须更换隐形眼镜时进行角膜测量。结果：21例患者中，男性15例，女性6例。术前，受影响眼和未受影响眼的IOP相似(9.5±3.5 vs. 9.2±2.8 mm Hg；P=0.502)和轴长(19.2±1.5∶19.4±0.96；P = 0.333)。病变眼的角膜直径小于未病变眼（10.2±0.7 vs 10.6±0.6 mm）；P = 0.002)。术后患眼最小分辨视力角度的对数逐渐改善，术后1年、2年、3年分别为1.12±0.28、0.78±0.37、0.62±0.38。正常眼分别为0.58±0.14、0.40±0.13和0.33±0.16。术后1年和3年的平均角膜屈光度和角膜屈光度比较，差异有统计学意义(2.09±1.21∶1.73±1.16 D， P=0.272；D = 44.82±3.15∶44.39±2.75，P=0.324)。随访期间无严重并发症发生。结论：硬晶状体在无晶状体眼中具有良好的耐受性和安全性，可有效提高儿童单侧白内障术后的视力。对于能够接受硬性角膜晶状体的患者，人工晶状体植入术可以推迟到三岁以后。
Rigid Corneal Lenses for Visual Rehabilitation in Infants With Unilateral Aphakia After Cataract Surgery: A Longitudinal Case Series.
Objectives: This study investigated the safety of rigid corneal lenses in children with unilateral aphakia after cataract surgery and observed the visual rehabilitation longitudinally.
Methods: This retrospective cohort study performed a 3-year follow-up of 21 infants (age 5.9±3.3 months) with unilateral congenital cataracts who started wearing rigid corneal contact lenses after cataract surgery. The basic presurgical patient information included chief complaint, intraocular pressure (IOP), axial length, corneal width, anterior segment, and fundus examination. The postsurgical visual acuity, IOP, and anterior segment were examined during regular postoperative follow-up visits. Keratometry was performed when contact lenses had to be changed.
Results: Of the 21 patients, 15 were male and 6 were female. Before surgery, the affected and nonaffected eyes had similar IOP (9.5±3.5 vs. 9.2±2.8 mm Hg; P =0.502) and axial length (19.2±1.5 vs. 19.4±0.96; P =0.333). The corneal diameter in the affected eyes was smaller than in the nonaffected eyes (10.2±0.7 vs. 10.6±0.6 mm; P =0.002). After surgery, the logarithm of the minimum angle of resolution vision of the affected eyes improved gradually, showing values of 1.12±0.28, 0.78±0.37, and 0.62±0.38 at 1, 2, and 3 years after surgery, respectively. The respective values in the unaffected eyes were 0.58±0.14, 0.40±0.13, and 0.33±0.16. The mean keratometric astigmatism and keratometry 1 and 3 years after surgery were statistically similar (2.09±1.21 vs. 1.73±1.16 D, P =0.272; 44.82±3.15 vs. 44.39±2.75 D, P =0.324, respectively). No serious complications occurred during the follow-up.
Conclusion: The rigid corneal lens is well tolerated and safe in aphakic eyes and can effectively improve children's visual acuity after unilateral cataract surgery. For patients able to receive rigid corneal lenses, intraocular lens implantation can be delayed until after the age of three.
期刊介绍：
Eye & Contact Lens: Science and Clinical Practice is the official journal of the Contact Lens Association of Ophthalmologists (CLAO), an international educational association for anterior segment research and clinical practice of interest to ophthalmologists, optometrists, and other vision care providers and researchers. Focusing especially on contact lenses, it also covers dry eye disease, MGD, infections, toxicity of drops and contact lens care solutions, topography, cornea surgery and post-operative care, optics, refractive surgery and corneal stability (eg, UV cross-linking). Peer-reviewed and published six times annually, it is a highly respected scientific journal in its field.
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