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Visual Outcome And Relevant Factors After Surgery Of Congenital Cataract

Posted on:2017-02-12Degree:MasterType:Thesis
Country:ChinaCandidate:P SunFull Text:PDF
GTID:2404330590990585Subject:Ophthalmology
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Objective To report visual outcome and evaluate its relative factors after congenital cataract surgery in children in the hope that it will provide references for the operation time and best optical correction regimen of infantile aphakia.Methods The records of 291 children(485eyes)opterated for congenital cataract at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2003 and June 2015 were reviewed retrospectively.The visual acuity,fixation,eye alignment and their influence factors,including laterality,ocular anomalies discovery age,lensectomy age,intraocular lens(IOL)implantation age,postoperative optical corretion methods and postoperative complicatios were evaluated.The SPSS 19.0 statistical program was used to analyse the results.Results 1.This retrospective study comprised 291 congenital cataract cases(178 male and 113 female;97 unilateral and 194 bilateral).The mean age at last follow-up was 54.4±35.8 months.The mean age when the eye anomalies were first noticed was 13.8±20.9 months and the unilateral patients were discovered later than bilateral cases.The mean lensectomy age at was 22.1±26.6 months.The mean primary IOL implantation age was 50.0±26.7 months and the mean secondary IOL implantation age was 60.7±22.1 months.92.7% aphakic eyes were corrected with aphakic glasses and 7.3% with rigid gas permeable contact lenses(RGPCL).The incidence of postoperative complications was 12%.2.The mean best corrected visual acuity(BCVA)of 238 eyes measured with standard logarithmic visual acuity chart was 0.29±0.22 and 0.10±0.12 of 137 eyes measured with LEA GRATINGS.BCVA of both eyes of 43.7% bilateral patients were less than 0.3 and 1.1% bilateral patients were less than 0.05.Patiants with bilateral cataract,ocular anomalies discovery age older than 12-month-old,lesectomy age younger than 3-month-old,unilateral aphakia with primarily IOL implantation before 24-month-old and aphakia corrected with RGPCL have better visual prognosis.3.Preoperative incidence of nystagmus were 68.5%,42.3% and 74.2% in total,unilateral and bilateral patients,respectively.Nystagmus prevalence of cases whose lensectomy age yonger than 3 months and older then 3 months were 62.5% and 84.1%.BCVA of patients with preoperative nystagmus was worse than that of patients without.4.Preoperative incidence of strabismus were 27.6%,54.5% and 19.0% in total,unilateral and bilateral patients,respectively.Strabismus prevalence of cases whose lensectomy age yonger than 6 months and older then 6 months were 21.0 % and 31.1%.BCVA of patients with preoperative strabismus was worse than that of patients without.Conclusion 1.The mean visual acuity at last follow-up was 0.29±0.22.BCVA of both eyes of43.7% bilateral patients was less than 0.3 and 1.1% bilateral patients was less than 0.05.BCVA of unilateral cataract eyes,patients whose eye anomalies discovery age younger than 12-month-old,cataract operation age 3-month-old,unilateral aphakia without primarily IOL implantation before 24-month-old aphakia corrected with aphakic glasses was worse than bilateral ones,discovery age older than 12-month-old,operation age older than 3-month-old,unilateral aphakia with primarily IOL implantation before 24-month-old and aphakia corrected with RGPCL.2.Preoperative incidence of nystagmus were 68.5% in total.Bilateral cases had higher nystagmus incidence than unilateral ones.Nystagmus prevalence of cases whose lensectomy age yonger than 3 months was lower than that of those older than 3 months.BCVA of patients with preoperative nystagmus was worse than that of patients without.3.Preoperative incidence of strabismus were 27.6% in total.Unilateral cases had higher strabismus incidence than bilateral ones.Strabismus prevalence of cases whose lensectomy age yonger than 6 months was lower than that of those older then 6 months.BCVA of patients with preoperative strabismus was worse than that of patients without.
Keywords/Search Tags:Cogenital Cataract, Visual Acuity, Nystagmus, Strabismus
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