Cataract surgery in the first year of life: aphakic glaucoma and visual outcomes.

Autor: Comer RM; Department of Ophthalmology, BC Children's Hospital, University of British Columbia, Vancouver, B.C., Canada., Kim P, Cline R, Lyons CJ
Jazyk: angličtina
Zdroj: Canadian journal of ophthalmology. Journal canadien d'ophtalmologie [Can J Ophthalmol] 2011 Apr; Vol. 46 (2), pp. 148-52.
DOI: 10.3129/i11-006
Abstrakt: Objective: To report the incidence of aphakic glaucoma following lensectomy in infants in their first year of life and examine the impact of this diagnosis on visual outcome.
Design: Retrospective cohort study.
Participants: All patients who had lensectomy for congenital cataract during the first year of life at British Columbia Children's Hospital between 1995 and 2006.
Methods: Retrospective review of medical records.
Results: Seventy-five eyes of 46 patients (29 bilateral, 17 unilateral) were included. The mean age at lensectomy was 93 days (range, 2-364 days) with a mean follow-up of 77.5 months (range, 36-166 months). Patients with bilateral cataracts had a better visual outcome than those with unilateral cataracts (p < 0.032). Of the patients with measurable visual acuity (VA), 34 of 45 eyes (75.6%) with bilateral cataracts and only 3 of 16 eyes (18.8%) with unilateral cataract achieved a VA of 20/40 or better. Eighteen of 75 eyes (24%) developed aphakic glaucoma at a mean of 30 months following lensectomy. Nine patients (50%) achieved final vision of 20/40 or better. The development of aphakic glaucoma was not associated with worse visual outcomes (p < 0.315). The mean intraocular pressure (IOP) at diagnosis was 28.6±5.9 mm Hg and mean final IOP was 14.1 ± 3.0 mm Hg, a significant reduction (p < 0.0001). Fifteen of 18 eyes with aphakic glaucoma (83.3%) required surgical intervention to achieve IOP control.
Conclusions: Children with aphakic glaucoma may have good visual outcomes if it is recognized early and managed appropriately. A significant proportion of patients required surgical intervention to control IOP.
Databáze: MEDLINE
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