单眼先天性白内障术后患儿眼球发育的自身对照观察

Autocontrol Observation of Ocular Development in Children with Monocular Congenital Cataract Surgery

目的探讨先天性白内障摘除联合前段玻璃体切除术后对眼轴和玻璃体发育的影响。方法回顾性病例研究。连续收集2015年3月至2019年3月于郑州大学第一附属医院行单眼先天性白内障手术的住院患儿60例(120只眼)。将符合纳入条件患儿根据眼别分为两组,手术眼为观察组,对侧正常眼为对照组。记录患儿的手术年龄、术前、术后1 a、术后2 a最佳矫正视力、眼压、眼轴长度以及眼轴长度变化量(术后眼轴长度减术前眼轴长度之差)、术前后B超和光学相干断层扫描(OCT)检查情况。结果共纳入60例患儿(120只眼),男28例,女32例;手术年龄(3.56±0.77)岁。术前、术后1 a、术后2 a观察组眼轴长度均短于对照组[(22.20±1.20)mm比(23.27±1.37)mm,(22.47±1.21)mm比(23.55±1.38)mm,(22.70±1.22)mm比(23.76±1.37)mm],差异均具有统计学意义(P<0.001)。术后1、2 a眼轴长度变化量,观察组和对照组差异均无统计学意义[(0.26±0.56)mm比(0.27±0.28)mm,P=0.151;(0.50±0.12)mm比(0.49±0.07)mm,P=0.759],术后1 a观察组与对照组玻璃体后脱离率差异无统计学意义(χ^(2)=2.226,P=0.272)。术后2 a观察组与对照组玻璃体后脱离率差异有统计学意义(χ^(2)=4.212,P=0.043)。术后1、2 a眼轴长度变化量与玻璃体后脱离均无相关性(r=0.459,P=0.626;r=-0.987,P=0.284)。结论先天性白内障患儿手术前后,手术眼眼轴长度均短于对侧正常眼,手术眼与对侧正常眼眼轴长度变化量相同。手术眼发生玻璃体后脱离率高于对侧正常眼。

Objective To investigate the effects of congenital cataract extraction combined with anterior vitrectomy on ocular axis and vitreous development.Methods Retrospective case series studies.A total of 60 children(120 eyes)who underwent unilateral congenital cataract surgery in the First Affiliated Hospital of Zhengzhou University were collected from March 2015 to March 2019.The children eligible for inclusion were divided into two groups according to their eye types.The operation eye was the observation group,and the normal eye was the control group.Age,the best corrected visual acuity,intraocular pressure,axial length and the change of axial length(the difference between postoperative axial length and preoperative axial length),B-ultrasound and/or optical coherence tomography(OCT)before and 1,2 years after surgery were recorded.Results A total of 60 children(120 eyes)were included,including 28 males and 32 females.The age of operation was(3.56±0.77)years old.The axial length of the observation group was shorter than that of the control group before,1 year and 2 years after surgery[(22.20±1.20)mm vs.(23.27±1.37)mm,(22.47±1.21)mm vs.(23.55±1.38)mm,(22.70±1.22)mm vs.(23.76±1.37)mm],and the differences were statistically significant(P<0.001).One year and 2 years after the surgery,the variable quantity of axial length was no significant difference between the observation group and the control group[(0.26±0.56)mm vs.(0.27±0.28)mm,P=0.151,(0.50±0.12)mm vs.(0.49±0.07)mm,P=0.759].There was no significant difference in the posterior vitreous detachment rate between the observation group and the control group 1 year after surgery(χ^(2)=2.226,P=0.272).The posterior vitreous detachment rate was significantly different between the observation group and the control group 2 years after surgery(χ^(2)=4.212,P=0.043).There was no correlation between the variable quantity of axial length and posterior vitreous detachment at 1 and 2 years after surgery(r=0.459,P=0.626,r=-0.987,P=0.284).Conclusion Before and after surgery,the axial length of the operation eye is smaller than that of the contralateral normal eye,and the variable quantity of axial length of the operation eye and contralateral normal eye are the same.The rate of posterior vitreous detachment in the operated eye is higher than that in the contralateral normal eye.