不同年龄婴幼儿单眼先天性白内障摘出术后眼球发育变化  

Eyeball development assessment following monocular congenital cataract extraction in different age infants

作　　者：毕玉滢 郑广瑛[1] 王华君[1] Bi Yuying;Zheng Guangying;Wang Huajun(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,450052

出　　处：《中华实验眼科杂志》2019年第4期276-281,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：河南省医学科技攻关计划项目(201202010).

摘　　要：目的探讨3~18个月龄单眼先天性白内障患儿术后眼轴长度、角膜曲率及屈光状态的变化和发育规律。方法采用回顾性队列研究方法,收集2015年1月至2017年12月在郑州大学第一附属医院诊治的3~18个月龄单眼先天性白内障患儿105例210眼的病历资料。患儿按初次接受白内障摘出术的年龄不同分为3~6个月组、7~12个月组和13~18个月组。术后随访12个月,评估术后3、6和12个月的眼轴长度、角膜曲率、检影验光的等效球镜度数。结果术后3、6和12个月,3~6个月组眼轴增长幅度大于7~12个月组,7~12个月组增长幅度大于13~18个月组。3~6个月组和7~12个月组术后各时间点术眼眼轴增长幅度均大于健眼,差异有统计学意义(P<0.001),13~18个月组术后6个月和12个月术眼眼轴增长幅度大于健眼,差异有统计学意义(P<0.001)。术前3个组患儿术眼眼轴均短于健眼,差异均有统计学意义(t=-10.420,P<0.001;t=-32.288,P<0.001;t=-2.370,P=0.024)。术后12个月,3~6个月组和7~12个月组术眼与健眼眼轴长度比较,差异均无统计学意义(P=0.051、0.062),13~18个月组术眼眼轴长度大于健眼,差异有统计学意义(t=18.513,P<0.001)。术前3~6个月组和7~12个月组术眼角膜曲率均大于健眼,差异均有统计学意义(均P<0.01),术前13~18个月组术眼角膜曲率与健眼比较,差异无统计学意义(P=0.433)。术后12个月,各组术眼角膜曲率与各自组内健眼比较,差异均无统计学意义(均P>0.05)。术后12个月,各组随着年龄增加屈光度变化量逐渐加大,差异均有统计学意义(均P<0.001)。术后12个月,3个组术眼屈光度变化量均大于健眼,差异均有统计学意义(均P<0.001)。结论3~18个月龄单眼先天性白内障患儿初次手术年龄越小,越能尽早解除形觉剥夺,术后无晶状体眼与健眼角膜曲率、眼轴长度均能保持协调发育;术后双眼屈光度均有向近视方向转变的趋势,且年龄越大,近视漂移的幅度�Objective To investigate the changes of the axial length,corneal curvature and refractive power in infants with monocular congenital cataract. Methods A retrospective cohort study was carried out.The clinical data of 105 eyes of 105 cases with monocular congenital cataract who were received cataract extraction during January 2015 to December 2017 were collected in the First Affiliated Hospital of Zhengzhou University.According to the initial operation age,the infants were assigned to 3-6 month old group,7-12 month old group and 13-18 month old group.The patients were followed-up for 12 months.Axial length,corneal curvature and refractive power were recorded in 3,6 and 12 months after surgery.This study followed the Declaration of Helsinki,and written informed consent was obtained from each guardian prior to any medical examination. Results The increasing value of axial length in 3-6 month old group was larger than that in 7-12 month old group,and increasing value in 7-12 month old group was larger than that in 13-18 month old group (all at P <0.001).The increasing value of axial length of operated eyes was larger than that of fellow eyes in both 3-6 month old group and 7-12 month old group during following-up,and so was in the 13-18 month old group at 6 months and 12 months after surgery (all at P <0.001).The ocular axial length of operated eyes was significantly shorter than that of the fellow eyes in three groups before operation ( t =-10.420, P <0.001;t =-32.288, P <0.001;t =-2.370, P =0.024),and at 12 months after operation,the axial length of operated eyes was longer than that of the fellow eyes in the 13-18 month old group ( t =18.513, P <0.001).No significant difference was found in the axial length between operated eyes and fellow eyes in both 3-6 month old group and 7-12 month old group ( P =0.051,0.062).The pre-operative corneal curvature was significantly larger than that of fellow eyes in both 3-6 month old group and 7-12 month old group (both at P <0.01),and was not significantly different in 13-18 m

关 键 词：先天性白内障 眼轴长度 角膜曲率 屈光度 

分 类 号：R779.66[医药卫生—眼科]