Abstract：
OBJECTIVE: To analyze the intraoperative challenges of cataract surgery in children, following glaucoma filtering surgery.
METHODS: This was a retrospective study to analyze intra-op challenges and outcomes of pediatric cataract surgery in post-glaucoma filtration surgery eyes, between January 2007 and December 2019.
RESULTS: We included 20 eyes of 16 children. The most common glaucoma surgery performed was trabeculectomy and trabeculotomy (14 eyes). The median age at the time of cataract surgery was 74.5 months. The most common cataract surgery performed was lens aspiration with posterior chamber intraocular lens implantation (LA + PCIOL) (9/20). The most common intraoperative challenge faced was difficulty in capsulorrhexis (ten eyes), followed by extension of primary posterior capsulotomy (six eyes). At the final follow up eight eyes had improvement in visual acuity, five eyes had stable visual acuity and five eyes had a drop in visual acuity. In 12/20 eyes IOL was implanted, nine eyes in-the-bag and three eyes had in ciliary sulcus. None of the IOLs in the bag had decentration of IOL. The median postoperative IOP (p = 0.12) and median number of postoperative AGM (p = 0.13) at 2 years remained stable compared to the preoperative values. The IOP remained well controlled in 4 eyes without anti-glaucoma medications and in 14 eyes with anti-glaucoma medications and none needed additional surgery for IOP control. Two eyes developed retinal detachment postoperatively.
CONCLUSIONS: Cataract surgery in pediatric eyes with prior glaucoma surgeries, have challenges with capsulorrhexis and IOL stability. The visual outcomes were reasonably good so was the IOP control.
METHODS: This was a retrospective study to analyze intra-op challenges and outcomes of pediatric cataract surgery in post-glaucoma filtration surgery eyes, between January 2007 and December 2019.
RESULTS: We included 20 eyes of 16 children. The most common glaucoma surgery performed was trabeculectomy and trabeculotomy (14 eyes). The median age at the time of cataract surgery was 74.5 months. The most common cataract surgery performed was lens aspiration with posterior chamber intraocular lens implantation (LA + PCIOL) (9/20). The most common intraoperative challenge faced was difficulty in capsulorrhexis (ten eyes), followed by extension of primary posterior capsulotomy (six eyes). At the final follow up eight eyes had improvement in visual acuity, five eyes had stable visual acuity and five eyes had a drop in visual acuity. In 12/20 eyes IOL was implanted, nine eyes in-the-bag and three eyes had in ciliary sulcus. None of the IOLs in the bag had decentration of IOL. The median postoperative IOP (p = 0.12) and median number of postoperative AGM (p = 0.13) at 2 years remained stable compared to the preoperative values. The IOP remained well controlled in 4 eyes without anti-glaucoma medications and in 14 eyes with anti-glaucoma medications and none needed additional surgery for IOP control. Two eyes developed retinal detachment postoperatively.
CONCLUSIONS: Cataract surgery in pediatric eyes with prior glaucoma surgeries, have challenges with capsulorrhexis and IOL stability. The visual outcomes were reasonably good so was the IOP control.
摘要：
目的：分析儿童白内障手术的术中挑战，青光眼滤过手术后。
方法：这是一项回顾性研究，旨在分析青光眼滤过术后眼的手术内挑战和小儿白内障手术的结果，2007年1月至2019年12月。
结果：我们纳入了16名儿童的20只眼。最常见的青光眼手术是小梁切除术和小梁切开术（14眼）。白内障手术时的中位年龄为74.5个月。最常见的白内障手术是晶状体抽吸和后房型人工晶状体植入术（LAPCIOL）（9/20）。术中最常见的挑战是撕囊困难（十只眼），随后进行原发性后囊切开术（六眼）。在最后的随访中，八只眼睛的视力有所改善，五只眼睛视力稳定，五只眼睛视力下降。在12/20眼中植入IOL，九只眼睛在包里，三只眼睛在睫状沟里。袋中的IOL均无IOL偏心。术后眼压中位数（p=0.12）和术后AGM中位数（p=0.13）在2年时与术前相比保持稳定。未使用抗青光眼药物的4只眼和使用抗青光眼药物的14只眼的IOP保持了良好的控制，没有需要额外的手术来控制IOP。两眼术后出现视网膜脱离。
结论：既往青光眼手术的儿童眼白内障手术，在撕囊和IOL稳定性方面存在挑战。视力结果相当好，IOP控制也是如此。
方法：这是一项回顾性研究，旨在分析青光眼滤过术后眼的手术内挑战和小儿白内障手术的结果，2007年1月至2019年12月。
结果：我们纳入了16名儿童的20只眼。最常见的青光眼手术是小梁切除术和小梁切开术（14眼）。白内障手术时的中位年龄为74.5个月。最常见的白内障手术是晶状体抽吸和后房型人工晶状体植入术（LAPCIOL）（9/20）。术中最常见的挑战是撕囊困难（十只眼），随后进行原发性后囊切开术（六眼）。在最后的随访中，八只眼睛的视力有所改善，五只眼睛视力稳定，五只眼睛视力下降。在12/20眼中植入IOL，九只眼睛在包里，三只眼睛在睫状沟里。袋中的IOL均无IOL偏心。术后眼压中位数（p=0.12）和术后AGM中位数（p=0.13）在2年时与术前相比保持稳定。未使用抗青光眼药物的4只眼和使用抗青光眼药物的14只眼的IOP保持了良好的控制，没有需要额外的手术来控制IOP。两眼术后出现视网膜脱离。
结论：既往青光眼手术的儿童眼白内障手术，在撕囊和IOL稳定性方面存在挑战。视力结果相当好，IOP控制也是如此。
