[1]孙洁,荆丽丽,代云海,等.先天性白内障手术后计划外再手术原因及相关危险因素研究[J].眼科新进展,2020,40(11):1041-1044.[doi:10.13389/j.cnki.rao.2020.0233]
 SUN Jie,JIN Lili,DAI Yunhai,et al.Causes of unplanned reoperations for congenital cataract and its related factors[J].Recent Advances in Ophthalmology,2020,40(11):1041-1044.[doi:10.13389/j.cnki.rao.2020.0233]
点击复制

先天性白内障手术后计划外再手术原因及相关危险因素研究/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年11期
页码:
1041-1044
栏目:
应用研究
出版日期:
2020-11-05

文章信息/Info

Title:
Causes of unplanned reoperations for congenital cataract and its related factors
作者:
孙洁荆丽丽代云海刘廷刘立波
266071 山东省青岛市,青岛大学医学部(孙洁);266071 山东省青岛市,山东第一医科大学附属青岛眼科医院 山东第一医科大学(山东省医学科学院)山东省眼科研究所 山东省眼科学重点实验室-省部共建国家重点实验室培育基地(孙洁,荆丽丽,代云海,刘廷);276300 山东省沂南县,山东大学齐鲁医院沂南分院沂南县人民医院(孙洁,刘立波)
Author(s):
SUN Jie123JIN Lili2DAI Yunhai2LIU Ting2LIU Libo3
1.Medical College of Qingdao University,Qingdao 266071,Shandong Province,China
2.Qingdao Eye Hospital of Shandong First Medical University,State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,Shandong Eye Institute,Shandong First Medical University & Shandong Academy of Medical Sciences,Qingdao 266071,Shandong Province,China
3.Yinan Branch of Qilu Hospital of Shandong University,Yinan 276300,Shandong Province,China
关键词:
先天性白内障术后并发症计划外再手术
Keywords:
congenital cataract postoperative complications unplanned reoperations
分类号:
R776
DOI:
10.13389/j.cnki.rao.2020.0233
文献标志码:
A
摘要:
目的 探讨先天性白内障手术后计划外再手术的原因及相关危险因素,为先天性白内障手术提供参考。方法 回顾性研究。收集2009年1月至2018年12月于青岛眼科医院就诊并行先天性白内障手术后计划外再次入院手术治疗的患者资料,分析患者再手术发生率、再手术时间以及发生原因等。结果 将白内障手术后计划外再手术36例(42眼)患者纳入本研究。计划外再手术占前三位的疾病分别为:后发性白内障(54.76%,23/42)、继发性青光眼(21.43%,9/42)、瞳孔闭锁(14.29%,6/42);其他原因有人工晶状体异位(7.14%,3/42)、视网膜脱离(2.38%,1/42)。计划外再手术发生率在0~3个月龄组为13.29%,显著高于4~12个月龄组(3.82%)和>12个月龄组(1.96%),组间差异有统计学意义(P=0.00);低月龄(≤3个月)白内障手术、一期未植入人工晶状体与后发性白内障、继发性青光眼和瞳孔闭锁均高度相关(均为P<0.05)。结论 后发性白内障、瞳孔闭锁和继发性青光眼为先天性白内障手术后计划外再手术的主要原因,低月龄(≤3个月)患者行白内障手术与计划外再手术高度相关。
Abstract:
Objective To investigate the causes and related risk factors of unplanned reoperations after congenital cataract surgery to provide reference for the surgery treatment of congenital cataract.Methods This was a retrospective cohort study. Data of patients admitted to Qingdao Eye Hospital from January 2009 to December 2018 who underwent unplanned readmission after congenital cataract surgery were collected to analyze the incidence of reoperation and the time and causes of reoperation.Results Thirty-six patients (42 eyes) with unplanned reoperations were included in the study. The top three causes for unscheduled reoperations were posterior capsule opacification (54.76%, 23/42), secondary glaucoma (21.43%, 9/42) and seclusion of pupil (14.29%, 6/42), while others were mainly caused by ectopic intraocular lens (7.14%, 3/42) and retinal detachment (2.38%, 1/42). The incidence of unplanned reoperation was 13.29% in the group aged between 0 to 3 months, 3.82% for the group aged 4 to 12 months and 1.96% for group aged over 12 months. There was significant difference between the groups (P=0.00). Cataract surgery for patients younger than 3 months and unimplanted intraocular lens at stage I cataract showed high correlativeness with posterior capsule opacification, secondary glaucoma and seclusion of pupils (all P<0.05).Conclusion Posterior capsule opacification, seclusion of pupils and secondary glaucoma are three main causes for unplanned reoperation of congenital cataract. Cataract surgery performed on patients aged less than 3 months presents a higher incidence for unplanned reoperations.

参考文献/References:

[1] HUANG B,HE W.Molecular characteristics of inherited congenital cataracts[J].Eur J Med Genet,2010,53(6):347-357.
[2] WILSON M E,PANDEY S K,THAKUR J.Pediatric cataract blindness in the developing world:surgical techniques and intraocular lenses in the new millennium[J].Br J Ophthalmol,2003,87(1):14-19.
[3] 祁锦艳,肖伟,王明玥,赵岱新,濮伟.婴幼儿先天性白内障吸除术后长期疗效观察[J].中华眼科杂志,2017,53(4):266-273.
QI J Y,XIAO W,WANG M Y,ZHAO D X,PU W.Long-term outcomes after cataract surgery in infants with congenital cataract[J].Chin J Ophthalmol,2017,53(4):266-273.
[4] LLOYD I C,ASHWORTH J,BISWAS S,ABADI R V.Advances in the management of congenital and infantile cataract[J].Eye,2007,21(10):1301-1309.
[5] 谢立信,黄钰森.儿童白内障学[M].北京:人民卫生出版社,2014.
XIE L X,HUANG Y S.Pediatric cataract[M].Beijing:People’s Medical Publishing House,2014.
[6] 赵于渔,赵云娥.先天性白内障形觉剥夺性弱视眼视网膜神经纤维层厚度的研究[J].国际眼科纵览,2019,43(3):199-203.
ZHAO Y Y,ZHAO Y E.The research of retinal nerve fiber layer thickness in eyes with form deprivation amblyopia due to congenital cataract[J].Int Rev Ophthalmol,2019,43(3):199-203.
[7] 毕玉滢,郑广瑛,王华君.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[J].中华实验眼科杂志,2019,37(4):276-281.
BI Y Y,ZHENG G Y,WANG H J.Eyeball development assessment following monocular congenital cataract extraction in different age infants[J].Chin J Exp Ophthalmol,2019,37(4):276-281.
[8] TRIVEDI R H,WILSON M E Jr,BARTHOLOMEW L R,LAL G,PETERSEIM M M.Opacification of the visual axis after cataract surgery and single acrylic intraocular lens implantation in the first year of life[J].J AAPOS,2004,8(2):156-164.
[9] NISHI O.Fibrinous membrane formation on the posterior chamber lens during the early postoperative period[J].J Cataract Refract Surg,1988,14(1):73-77.
[10] BASTI S,RAVISHANKAR U,GUPTA S.Results of a prospective evaluation of three methods of management of pediatric cataracts[J].Ophthalmology,1996,103(5):713-720.
[11] ATKINSON C S,HILES D A.Treatment of secondary posterior capsular membranes with the Nd:YAG laser in a pediatric population[J].Arch Ophthalmol,1994,118(4):496-501.
[12] LUNDVALL A,ZETTERSTR M C.Primary intraocular lens implantation in infants:complications and visual results[J].J Cataract Refract Surg,2006,32(10):1672-1677.
[13] VERA L,LAMBERT N,SOMMET J,BOULKEDID R,ALBERTI C,BUIQUOC E.Visual outcomes and complications of cataract surgery with primary implantation in infants[J].J Fr Ophthalmol,2017,40(5):386-393.
[14] BUEHL W,FINDL O.Effect of intraocular lens design on posterior capsule opacification[J].J Cataract Refract Surg,2008,34(11):1976-1985.
[15] LIN H,OUYANG H,ZHU J,HUANG S,LIU Z,CHEN S,et al.Lens regeneration using endogenous stem cells with gain of visual function[J].Nature,2016,531(7594):323-328.
[16] WONG I B Y,SUKTHANKAR V D,CORTINA-BORJA M,NISCHAL K K.Incidence of early-onset glaucoma after infant cataract extraction with and without intraocular lens implantation[J].Br J Ophthalmol,2009,93(9):1200-1203.
[17] HAARGAARD B,RITZ C,OUDIN A,WOHLFAHRT J,THYGESEN J,OLSEN T,et al.Risk of glaucoma after pediatric cataract surgery[J].Invest Ophthalmol Vis Sci,2008,49(5):1791-1796.
[18] KUHLI-HATTENBACH C,LüCHTENBERG M,KOHNEN T,HATTENBACH L O.Risk factors for complications after congenital cataract surgery without intraocular lens implantation in the first 18 months of life[J].Am J Ophthalmol,2008,146(1):1-7.
[19] KIRWAN C,LANIGAN B,O’KEEFE M.Glaucoma in aphakic and pseudophakic eyes following surgery for congenital cataract in the first year of life[J].Acta Ophthalmol,2010,88(1):53-59.
[20] MATAFTSI A,HAIDICH A B,KOKKALI S,RABIAH P K,BIRCH E,STAGER D R Jr,et al.Postoperative glaucoma following infantile cataract surgery:an individual patient data Meta-analysis[J].JAMA Ophthalmol,2014,132(9):1059-1067.
[21] SUN X,DAI Y,CHEN Y,YU D Y,CRINGLE S J,CHEN J,et al.Primary angle closure glaucoma:what we know and what we don’t know?[J].Prog Retin Eye Res,2017,57(1):26-45.
[22] 吴晓明,由彩云,代云海,黄钰森,谢立信.婴儿先天性白内障术后虹膜粘连的特点和影响因素分析[J].中华眼视光学与视觉科学杂志,2010,12(2):127-130.
WU X M,YOU C Y,DAI Y H,HUANG Y S,XIE L X.Analysis of risk factors for iris synechia formation after infantile congenital cataract surgery[J].Chin J Optom Ophthalmol Vis Sci,2010,12(2):127-130.
[23] CLEARY C A,LANIGAN B,O’KEEFFE M.Intracameral triamcinolone acetonide after pediatric cataract surgery[J].J Cataract Refract Surg,2010,36(10):1676-1681.
[24] MATAFTSI A,DABBAGH A,MOORE W,NISCHAL K K.Evaluation of whether intracameral dexamethasone predisposes to glaucoma after pediatric cataract surgery[J].J Cataract Refract Surg,2012,38(10):1719-1723.
[25] VASAVADA V A,PRAVEEN M R,SHAH S K,TRIVEDI R H,VASAVADA A R.Anti-inflammatory effect of low-molecular-weight heparin in pediatric cataract surgery:a randomized clinical trial[J].Am J Ophthalmol,2012,154(2):252-258.
[26] GRADIN D,MUNDIA D.Effect of intracameral cefuroxime on fibrinous uveitis after pediatric cataract surgery[J].J Pediatr Ophthalmol Strab,2011,48(1):45-49.
[27] 朱彰灏.儿童白内障手术并发症的研究进展[J].中华实验眼科杂志,2017,35(3):273-276.
ZHU Z H.Update of pediatric cataract surgery complications[J].Chin J Exp Ophthalmol,2017,35(3):273-276.
[28] RABIAH P K,DU H,HAHN E A.Frequency and predictors of retinal detachment after pediatric cataract surgery without primary intraocular lens implantation[J].J AAPOS,2005,9(2):152-159.
[29] FOSTER A,GILBERT C.Cataract in children[J].Acta Pediatr,2003,92(12):1376-1378.

相似文献/References:

[1]邵珺 朱靖 储兆东 禹倩倩 陶永辉 黄玉政 姚勇.先天性白内障患者和正常人晶状体蛋白质组的差异分析[J].眼科新进展,2013,33(4):000.
[2]王明玥,肖伟,濮伟,等.婴儿先天性白内障摘出术后早期中央角膜厚度变化与眼压的相关性研究[J].眼科新进展,2015,35(10):931.[doi:10.13389/j.cnki.rao.2015.0254]
 WANG Ming-Yue,XIAO Wei,PU Wei,et al.Central corneal thickness changes of infantal congenital cataracts and its correlation with intraocular pressure following extraction surgery[J].Recent Advances in Ophthalmology,2015,35(11):931.[doi:10.13389/j.cnki.rao.2015.0254]
[3]张丁丁,李秀兰.X-连锁遗传相关的先天性白内障及基因研究进展[J].眼科新进展,2016,36(5):481.[doi:10.13389/j.cnki.rao.2016.0129]
 ZHANG Ding-Ding,LI Xiu-Lan.Research advances in the Gene Study of X-linked congenital cataract[J].Recent Advances in Ophthalmology,2016,36(11):481.[doi:10.13389/j.cnki.rao.2016.0129]
[4]淦强,刘琼,叶波,等.应用25G玻璃体切割系统治疗婴幼儿先天性白内障[J].眼科新进展,2016,36(9):870.[doi:10.13389/j.cnki.rao.2016.0233]
 GAN Qiang,LIU Qiong,YE Bo,et al.Application of 25G vitreous surgery system in the treatment of congenital cataract of infant[J].Recent Advances in Ophthalmology,2016,36(11):870.[doi:10.13389/j.cnki.rao.2016.0233]
[5]杨琳,吕勇,周朋义,等.儿童先天性白内障476例手术特点分析[J].眼科新进展,2017,37(8):743.[doi:10.13389/j.cnki.rao.2017.0188]
 YANG Lin,LV Yong,ZHOU Peng-Yi,et al.Clinical characteristics of congenital cataract in 476 children[J].Recent Advances in Ophthalmology,2017,37(11):743.[doi:10.13389/j.cnki.rao.2017.0188]
[6]王凡,陈迪,焦婷,等.中国北方一先天性白内障家系GJA8基因新突变[J].眼科新进展,2019,39(9):854.[doi:10.13389/j.cnki.rao.2019.0194]
 WANG Fan,CHEN Di,JIAO Ting,et al.New mutation of GJA8 gene in a family with congenital cataract in northern China[J].Recent Advances in Ophthalmology,2019,39(11):854.[doi:10.13389/j.cnki.rao.2019.0194]
[7]谌文思,项道满.基于超声生物显微镜图像分型的先天性白内障摘出术后后发性白内障的手术设计及疗效观察[J].眼科新进展,2019,39(11):1063.[doi:10.13389/j.cnki.rao.2019.0244]
 CHEN Wen-Si,XIANG Dao-Man.Surgical design and effect of posterior capsule opacification after extraction of congenital cataract based on ultrasound biomicroscopy image classification[J].Recent Advances in Ophthalmology,2019,39(11):1063.[doi:10.13389/j.cnki.rao.2019.0244]
[8]徐晓玮,田爱军,郝微,等.不同手术入路的微创玻璃体切割系统对先天性白内障患儿术后并发症的影响[J].眼科新进展,2020,40(1):062.[doi:10.13389/j.cnki.rao.2020.0015]
 XU Xiaowei,TIAN Aijun,HAO Wei,et al.Effects of different surgical approaches of minimally invasive vitrectomy on complications after congenital cataract surgery[J].Recent Advances in Ophthalmology,2020,40(11):062.[doi:10.13389/j.cnki.rao.2020.0015]
[9]孙重,张莹,吴作红,等.P50和P200型 Ex-PRESS青光眼引流钉治疗原发性开角型青光眼的疗效及安全性对比[J].眼科新进展,2021,41(2):162.[doi:10.13389/j.cnki.rao.2021.0034]
 SUN Zhong,ZHANG Ying,WU Zuohong,et al.Comparison of the therapeutic efficacy and safety of P50 and P200 Ex-PRESS miniature glaucoma device implantation for primary open-angle glaucoma[J].Recent Advances in Ophthalmology,2021,41(11):162.[doi:10.13389/j.cnki.rao.2021.0034]
[10]王珏雪,万修华.先天性白内障晶状体蛋白致病基因及其功能研究进展[J].眼科新进展,2023,43(8):656.[doi:10.13389/j.cnki.rao.2023.0133]
 WANG Juexue,WAN Xiuhua.Research progress of pathogenic crystallin genes on congenital cataract and their functions[J].Recent Advances in Ophthalmology,2023,43(11):656.[doi:10.13389/j.cnki.rao.2023.0133]

备注/Memo

备注/Memo:
国家自然科学基金资助(编号:81600721)
更新日期/Last Update: 2020-11-05