聚丙烯巩膜缝合固定人工晶状体治疗儿童非外伤性晶状体异位的疗效和安全性：一项现实世界研究。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-05-06 DOI:10.1016/j.ajo.2025.04.036

Siyuan Liu , Xinyu Zhang , Zhenzhen Liu , Charlotte Young , Zhangkai Lian , Danying Zheng , Guangming Jin

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引用次数: 0

摘要

目的报道巩膜缝合固定人工晶状体（SFIOL）治疗儿童非外伤性晶状体异位（EL）的疗效和安全性。design回顾性案例系列。方法回顾性研究在中山大学中山眼科中心对123例非外伤性EL患儿220只眼进行了至少3年的术后随访。所有眼均行原发性SFIOL晶状体摘除术。疗效指标为术后矫正距离视力（CDVA）。安全性结果是术后并发症和额外手术的发生率。次要结果为屈光和人工晶状体浓度的变化。结果队列患者平均手术年龄为7.62±3.41岁，中位随访时间为4.04年（IQR, 3.41 ~ 5.17）年。最终随访时，87.2%的眼睛CDVA≥0.5。术后并发症包括缝线暴露19眼（8.6%），IOL脱位17眼（7.7%），IOL瞳孔捕获7眼（3.2%），持续高眼压4眼（1.8%），视网膜脱离3眼（1.3%），眼内炎2眼（0.9%）。附加手术率为7.7%，其中视网膜脱离3眼，人工晶状体脱位14眼。术后屈光有近视眼的倾向。人工晶状体平均倾斜8.6±5.7°，离体0.75±0.38mm。结论非外伤性肠内瘘是治疗儿童肠内瘘的有效方法，但存在一定的并发症。缝线暴露和人工晶状体脱位是最常见的并发症，并可能随着时间的推移而发生。加强术后长时间随访对非外伤性肠外疝患儿至关重要。

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Efficacy and Safety of Polypropylene Scleral Suture Fixation of Intraocular Lens in Pediatric Nontraumatic Ectopia Lentis: A Real-World Study

PURPOSE

To report the efficacy and safety of scleral-suture fixation of intraocular lens (SFIOL) in children with nontraumatic ectopia lentis (EL) in a real-world setting.

DESIGN

Retrospective case series.

METHODS

The retrospective study included 220 eyes of 123 children with nontraumatic EL completing a minimum of 3 years of postoperative follow-up, and was conducted at the Zhongshan Ophthalmic Center, Sun Yat-sen University (Guangzhou, China). Lens extraction with primary SFIOL was performed in all eyes. The efficacy outcome was postoperative corrected distance visual acuity (CDVA). The safety outcomes were postoperative complications and the rate of additional surgery. The secondary outcomes were change in refraction and IOL centration.

RESULTS

The mean age at surgery of the cohort was 7.62 ± 3.41 years, and the median follow-up duration was 4.04 (interquartile range [IQR] = 3.41-5.17) years. In all, 87.2% eyes had CDVA greater than or equal to 0.5 at final follow-up. The postoperative complications included suture exposure in 19 eyes (8.6%), IOL dislocation in 17 eyes (7.7%), IOL pupillary capture in 7 eyes (3.2%), persistent high intraocular pressure in 4 eyes (1.8%), retinal detachment in 3 eyes (1.3%), and endophthalmitis in 2 eyes (0.9%). The additional surgery rate was 7.7%, including retinal detachment in 3 eyes and IOL dislocation in 14 eyes. The postoperative refraction showed a tendency toward myopia. The mean IOL tilt and decentration were 8.6 ± 5.7° and 0.75 ± 0.38 mm, respectively.

CONCLUSIONS

SFIOL is an effective method for managing children with nontraumatic EL, but with a certain incidence of complications. Suture exposure and IOL dislocation are the most common complications and may occur over time. Strengthening the postoperative long-term follow-up is crucial for children with nontraumatic EL.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.