先天性纤维血管瞳孔膜患儿的眼部生物学参数和屈光状况

目的：观察先天性纤维血管瞳孔膜（CFPM）患儿的临床表现、术前生物学参数及术后屈光状况。方法：回顾性系列病例研究。分析2016年7月至2019年12月在温州医科大学附属眼视光医院杭州院区接受手术治疗的CFPM患儿13例（15眼）的临床资料，其中11例单眼发病，2例双眼发病。记录患儿手术年龄、合并症、眼部生物学参数、手术方式以及术后1周验光结果。将10例单眼发病（1例继发青光眼，数据剔除）的CFPM患儿分为患眼组与对侧健眼组，比较2组眼轴、角膜屈光力和术后验光结果。采用配对t检验比较CFPM患眼组及对侧健眼组生物参数测量值差异。结果：13例患儿合并症包括先天性白内障、永存性瞳孔残膜、斜视和继发性青光眼等（双眼患儿中的1例因1眼未行手术治疗，数据剔除）。患眼组的眼轴（19.87±2.01）mm]较对侧健眼组（20.38±1.76）mm]短，等效球镜度（3.41±2.29）D]较对侧健眼组（2.24±1.49）D]高，但是差异无统计学意义。患眼组（42.31±2.75）和对侧健眼组（42.40±1.05）角膜屈光力相近（t=-0.096，P=0.926）。结论：CFPM可同时伴发其他合并症。与对侧健康眼相比，CFPM患眼可能存在眼轴偏短，远视度数偏高的情况。临床上对该类患儿应重视术前生物参数以及术后屈光状况的测量并及时进行弱视和斜视的治疗。

Ocular Biometric Parameters and Refraction in Children with Congenital Fibrovascular Pupillary Membranes

Objective:To investigate the clinical characteristics,ocular biometric parameters and refraction of congenital fibrovascular pupillary membrane(CFPM)patients.Methods:This retrospective study included 15 eyes of 13 CFPM patients(11 unilateral cases,2 bilateral cases)who underwent surgical treatment from July 2016 to December 2019 at the Eye Hospital,Wenzhou Medical University(Hangzhou).Age at surgery,concurrent eye anomalies,ocular biometric parameters,surgical approaches and refraction 1 week after surgery were recorded.Ten unilateral CFPM patients(1 patient excluded for secondary glaucoma)were divided into the CFPM group and the contralateral control group.Axial length(AL),corneal power and postoperative refraction were compared between the two groups.A paired t test was used to compare the differences in biological parameters between the CFPM group and the contralateral healthy eye group.Results:The concurrent eye anomalies of 13 CFPM patients included congenital cataract,persistent pupillary membrane(PPM),strabismus and secondary glaucoma(the data of one eye of a bilateral case excluded for did not undergo surgery).The AL of the CFPM group(19.87±2.01 mm)was shorter than that of the control group(20.38±1.76 mm),and the postoperative spherical equivalent(3.41±2.29 D)was higher than that of the control group(2.24±1.49 D),but the differences were not statistically significant.Corneal power was close between the two groups(mean corneal power 42.31±2.75 D vs.42.40±1.05 D,t=-0.096,P=0.926).Conclusions:CFPM maybe accompanied by other concurrent eye anomalies.Compared to the contralateral healthy eye,CFPM eyes present a shorter axial length and higher hyperopia.Clinicians should pay attention to the ocular biometric parameters of CFPM patients preoperatively and refraction postoperatively,treating amblyopia and strabismus in a timely manner.