婴幼儿先天性白内障摘除术后无晶状体眼青光眼危险因素分析

Risk factor analysis ofaphakic glaucoma following infant cataract surgery

目的探讨婴幼儿先天性白内障摘除术后发生无品状体青光眼的规律和特点。方法回顾2001年9月至2009年9月间接受先天性白内障手术的婴幼儿患者228例（395只眼）。白内障摘除手术两周后眼压高于25mmHg的患儿被视为无晶状体青光眼；术后随访时间为（56±13）月；追踪观察到眼压〉25mmHg的患儿有63只眼（15．9％）。结果对术后患儿术眼眼压观察结果进行统计学危险因素分析：出生后〈3月接受手术患儿，白内障摘除术后发生青光眼的危险性是13～36月接受手术患儿的13．429倍（P=0．001，OR=13．429）；出生后3-6月接受手术患儿，发生青光眼的危险性是13～36月接受手术患儿的6．889倍（P=0．008，OR=6．889）；在先天性白内障各种晶状体混浊形态中，核性白内障摘除术后无晶状体青光眼发病率最高；其危险性是全白内障的3．759倍（P=0．004，OR=3．759）；其它形态的白内障与全白内障比较，术后发生青光眼的危险性没有统计学意义（P〉0．05）；合并眼部其它先天异常的患儿，其自内障摘除术后发生无晶状体青光眼的危险性是单纯性白内障的21．382倍（P=0．000，OR值为21．382）。结论年龄过小、核性白内障及合并眼部其他先天性疾病是婴幼儿时期先天l生白内障摘除手术后无晶状体青光眼发生的危险因素。

[Abstract] Objective To study and analyze the rules and characteristics of the development ofaphakic glaucoma （AG） following infant cataract surgery. Methods A retrospective study of 228 cases （395 eyes） who received cataract surgery in Shengjing Hospital from September, 2001 to September, 2009. AG Was defined as a repeated ocular hypertension （〉25mmHg） over 2 weeks after cataract surgery. The postoperative follow-up was x± s （56＋ 13） mo. Sixty-three eyes （15.9%） had the presence of AG. Results The OR value of 〈3mo group was 13.429 （P=0.001）, 3-6 mo group was 6.889 （P =0.008）. The patients with nuclear cataract had the highest risk of AG （OR=3.759, P=0.004） among other cataract types. Cataract infants with other ocular abnormalities also had an extremely high risk of AG compared with simple cataract （OR=21.382, P =0.000）. Conclusions Cataract surgery in earlier infancy, nuclear cataract and cataract with other ocular abnormalities are likely the risk factors of AG after infant cataract surgery.