目的:比较先天性风疹综合征(CRS)患儿与非风疹性白内障患儿婴儿期白内障术后继发性青光眼的发生率,并探讨相关危险因素。
方法:回顾性病例对照研究。
方法:纳入婴儿期接受白内障手术的CRS患儿和因婴儿白内障而接受白内障手术的年龄匹配的婴儿。
方法:比较两组的青光眼发生率和生存概率。评估青光眼发展的危险因素。最低随访时间为白内障术后1年。
结果:该研究包括115名儿童的211只眼。CRS组(病例)101眼(58例儿童),非风疹性白内障组(对照)110眼(57例儿童)。两组之间的手术平均年龄没有显着差异(p=0.96)。在整个14年的研究期间,CRS组为32.7%,对照组为24.5%(p=0.19)。CRS组的平均随访时间为5.8±3.7年,非风疹组的平均随访时间为6.4±3.4年。白内障手术后10年无青光眼生存的累积概率存在显着差异(病例0.53与对照组0.8;log秩p-0.034)。两组在继发性青光眼的发病时间上无显著性差异,降低眼压药物的平均数量和手术治疗青光眼的眼睛数量(p>0.05)。在CRS眼中,微角膜与青光眼的发展有关(风险比2.83,95%置信区间1.44-5.57;p=0.002)。
结论:与接受婴儿白内障手术的婴儿相比,患有CRS的婴儿进行白内障手术后继发性青光眼的发生率没有显着差异。由于CRS患儿无青光眼生存的十年概率明显较低,建议进行更近距离和更长时间的随访,尤其是在具有高危特征的眼睛中.
OBJECTIVE: To compare the incidence of secondary glaucoma after cataract surgery performed in infancy in children with congenital rubella syndrome (CRS) and children with nonrubella cataracts and to identify associated risk factors.
METHODS: Retrospective case control study.
METHODS: Children with CRS who had undergone cataract surgery in infancy and age-matched infants who had undergone cataract surgery for infantile cataracts were included.
METHODS: Incidence of glaucoma and probability of survival was compared among the 2 groups.
METHODS: Risk factors for the development of glaucoma were assessed. The minimum follow-up was 1 year after cataract surgery.
RESULTS: The study included 211 eyes of 115 children. The CRS group (cases) had 101 eyes (58 children) and the nonrubella cataract group (controls) included 110 eyes (57 children). There was no significant difference in the mean age at surgery among the 2 groups (P = 0.96). Cumulative incidence of secondary childhood glaucoma for the entire study period of 14 years was 32.7% in the CRS group and 24.5% in the control group (P = 0.19). Mean follow-up was 5.8 ± 3.7 years for CRS group and 6.4 ± 3.4 years for the nonrubella group. A significant difference in the cumulative probability of glaucoma free survival at 10 years after cataract surgery (cases 0.53 vs controls 0.8; log rank P = 0.034) was present. Both groups had no significant difference in the time of onset of secondary glaucoma, average number of intraocular pressure lowering medications and number of eyes with surgical intervention for glaucoma (P > 0.05). Microcornea was associated with the development of glaucoma (hazard ratio 2.83; 95% confidence interval, 1.44-5.57; P = 0.002) in CRS eyes.
CONCLUSIONS: There was no significant difference in the incidence of secondary glaucoma after cataract surgery performed in infants with CRS compared with infants who had undergone surgery for infantile cataracts. Because the 10-year probability of glaucoma free survival was significantly less in children with CRS, a closer and longer follow-up is recommended especially in eyes with at-risk features.
BACKGROUND: The author(s) have no proprietary or commercial interest in any materials discussed in this article.