| 婴幼儿人工晶状体植入术后屈光状态变化的长期观察 |
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| 引用本文： | 王明玥,肖伟,濮伟,赵岱新. 婴幼儿人工晶状体植入术后屈光状态变化的长期观察[J]. 眼科新进展, 2018, 0(11): 1045-1049. DOI: 10.13389/j.cnki.rao.2018.0246 |
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| 作者姓名： | 王明玥 肖伟 濮伟 赵岱新 |
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| 作者单位： | 110004 辽宁省沈阳市，中国医科大学附属盛京医院眼科 |
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| 摘 要： | 目的 研究婴幼儿人工晶状体（intraocular lens，IOL）植入术后的屈光状态的变化，为婴幼儿白内障患者植入IOL的屈光度及预留远视屈光度的临床应用提供依据。方法 回顾性分析中国医科大学附属盛京医院2006年5月至2017年5月手术治疗的婴幼儿白内障患儿38例（65眼），随访时间（3.55±2.46）a；按植入IOL时的月龄和植入IOL时的眼轴长度分别分组。通过组间比较、回归分析眼轴长度、植入IOL时年龄、植入IOL度数、预留屈光度、术后屈光状态等的关系。结果 年龄≤24个月组及＞24个月组两组间植入IOL度数、预留屈光度、末次随访时年龄差异均有统计学意义（均为P＜0.05），IOL植入时眼轴长度、随访时间、末次随访时眼轴长度、末次随访时屈光状态差异均无统计学意义（均为P>0.05）；两组间末次随访时屈光状态达到理想屈光度±1.00 D内的百分比相比差异无统计学意义（P>0.05），达到±2.00 D内及±3.00 D内的百分比相比差异均有统计学意义（均为P<0.05）。植入IOL时眼轴长度＜21 mm、21~<22 mm、≥22 mm 3组间IOL植入时眼轴长度、植入IOL度数、预留屈光度、随访时间、末次随访时眼轴长度差异均有统计学意义（均为P＜0.05）；3组间末次随访时屈光状态差异无统计学意义（P>0.05）；3组间末次随访时屈光状态达到理想屈光度±1.00 D内、±2.00 D内及±3.00 D内的百分比相比差异均无统计学意义（均为P>0.05）。65眼中28眼（43.1%）末次随访时屈光状态可达到理想屈光度±1.00 D内，44眼（67.7%）末次随访时屈光状态在预期屈光度±2.00 D内，52眼（80.0%）末次随访时屈光状态在预期屈光度±3.00 D内。术后近视漂移度数与手术时月龄相关，末次随访时屈光状态与末次随访时眼轴长度、IOL植入手术时月龄、末次随访时年龄相关。预留屈光度（Y）与IOL植入时月龄（X1）及IOL植入时眼轴长度（X2）相关，Y=13.599-0.043X1-0.427X2 （R2=0.674，F=64.225，P＜0.001）。结论 根据婴幼儿白内障患者个体化眼轴发育的不同，参照婴幼儿IOL植入时屈光度预留方案来确定预植入的IOL度数，在患儿发育到学龄期时，患眼可以达到或接近正常儿童屈光状态。
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| 关 键 词： | 婴幼儿白内障 人工晶状体 屈光度 预留远视屈光度 |
Long-term observation of refraction after pediatric intraocular lens implantation |
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| WANG Ming-Yue,XIAO Wei,PU Wei,ZHAO Dai-Xin. Long-term observation of refraction after pediatric intraocular lens implantation[J]. Recent Advances in Ophthalmology, 2018, 0(11): 1045-1049. DOI: 10.13389/j.cnki.rao.2018.0246 |
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| Authors: | WANG Ming-Yue XIAO Wei PU Wei ZHAO Dai-Xin |
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| Affiliation: | Department of Ophthalmology，Shengjing Hospital of China Medical University，Shenyang 110004，Liaoning Province，China |
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| Abstract: | Objective To study the changes in refraction after intraocular lens(IOL) implantation in infants and young cataract children,and to provide evidence for the clinical application of IOL power and designed postoperative hyperopic diopter.Methods A retrospective analysis of 38 children (65 eyes) of infants and young children patients with cataract from May 2006 to May 2017 in Shengjing Hospital,China Medical University was done.The average follow-up time was (3.55±2.46)years.The patients were divided into two groups according to the age of IOL implantation while they were divided into three groups according to the axial length at the time of IOL implantation.The changes in ocular axis,implanted IOL power,designed postoperative hyperopic diopter,refractionand the relationship between the designed postoperative hyperopic diopter and the age and the axis lengthof IOL implantation were studied by regression analysis and comparison between groups.Results Between the two groups of age ≤24 months and ＞24 months,there were significant statistical differences in the IOL power,designed postoperative hyperopic diopter and the age at the time of last follow-up (all P<0.05).There was no significant statistical difference in the axial length at the time of IOL implantation,the follow-up time,the axial length and the refraction at the last follow-up (all P>0.05).There was no significant statistical difference in the percentage that could reach the ideal refraction range within ±1.00 D at the last follow-up (P>0.05).There were significant statistical differences in the percentage that could reach the ideal refraction range within ±2.00 D and ±3.00 D at the last follow-up(all P<0.05).Between the 3 groups that axial length <21 mm,21~<22 mm and ≥22 mm,there were significant statistical differences in the axial length at the time of IOL implantation,the IOL power,designed postoperative hyperopic diopter,the follow-up time,the axial length at the time of last follow-up (all P<0.05).There was no significant statistical difference in refraction at the time of last follow-up.There was no significant statistical difference in the percentage that could reach the ideal refraction range within ±1.00 D,±2.00 D and ±3.00 D at the last follow-up.In this study,28 eyes (43.1%) could reach the ideal refraction range within ±1.00 D,44 eyes (67.7%) could reach the ideal refraction range within ±2.00 D and 52 eyes (80%) could reach the ideal refraction range within ±3.00 D.The postoperative myopia drift was associated with month age of surgery.The refraction at the time of last follow-up was associated with the axial length,the month age of IOL implantation and the age at the time of last follow-up.In this study,the designed postoperative hyperopic diopter (Y) was related to the month age (X1) and axial length (X2) at the time of IOL implantation,Y=13.599-0.043X1-0.427X2(R2= 0.674,F=64.225,P<0.001).Conclusion According to the different individual development of ocular axial,the implanted IOL calculation for pre-school-age children patients can be determined by referencing the procedure of designed postoperative hyperopic diopter at the time of IOL implantation,which can reach or approach the normal children’s refractive status when the patients reach to the school age. |
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| Keywords: | pediatric cataract intraocularlens refraction designed postoperative hyperopic diopter |
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