Annamária Náray, Fabian N Fries, Cristian Munteanu, Mária Csidey, Tanja Stachon, Neil Lagali, Achim Langenbucher, Barbara Käsmann-Kellner, Berthold Seitz, Nóra Szentmáry
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引用次数: 0
Abstract
Purpose: The potential risks and benefits of cataract surgery, in context of congenital aniridia (CA), are not widely understood, yet. Our purpose was to investigate the effect of lens properties on visual acuity (VA), aniridia-associated keratopathy (AAK) stage and presence of glaucoma at the Homburg Aniridia Center.
Methods: CA subjects, examined at the Department of Ophthalmology of Saarland University between June 2003 and January 2022, were included. VA, slit-lamp examination, AAK grade, and glaucoma evaluation data were extracted from the medical records, from the first visit to the center. Eyes were categorized as clear lens, cataract, pseudophakic, aphakic, or subluxated lens. Patients were grouped by age (0-10, 10-20, 20-40, 40+ years).
Results: In 553 eyes of 286 CA subjects (age 19.9 ± 19.9 (0-83) years, 46.1% males), analysis revealed significant differences in VA and mean IOP (ANOVA p < 0.0001; p = 0.001, respectively) with lens status. Lens status was strongly associated with AAK Grade and glaucoma presence (p < 0.0001 for both). In age subgroups, AAK Stage was strongly associated with lens status in the 0-10 years (p < 0.001), 10-20 years (p < 0.001), and 40+ years (p = 0.02) groups and lens status was strongly associated with glaucoma presence in the 0-10 years (p = 0.003) and 20-40 years (p = 0.002) groups. AAK Stage was the most advanced in pseudophakic and aphakic eyes and presence of glaucoma was more pronounced in pseudophakic, aphakic and subluxated lens eyes.
Conclusions: In a large population of CA, previous cataract surgery was associated with higher AAK Grade and presence of secondary glaucoma both in postoperatively pseudophakic and aphakic eyes. Our data indicate that caution is warranted with cataract surgery in congenital aniridia.
目的：在先天性无虹膜（CA）的情况下，白内障手术的潜在风险和益处尚未被广泛了解。我们的目的是研究在Homburg无虹膜中心晶状体性能对视力（VA）、无虹膜相关性角膜病变（AAK）分期和青光眼的影响。方法：纳入2003年6月至2022年1月在萨尔大学眼科检查的CA受试者。VA、裂隙灯检查、AAK评分和青光眼评估数据提取自首次到中心就诊的病历。眼睛分为透明晶状体、白内障、假性晶状体、无晶状体和半脱位晶状体。患者按年龄分组（0-10岁、10-20岁、20-40岁、40+岁）。结果：286例CA患者553只眼（年龄19.9±19.9（0-83）岁，男性46.1%），VA和平均IOP随晶状体状态差异有统计学意义（方差分析p = 0.001）。晶状体状态与AAK分级和青光眼存在密切相关（p p p p = 0.02），晶状体状态与0-10岁组青光眼存在密切相关（p = 0.003）和20-40岁组青光眼存在密切相关（p = 0.002）。AAK期在假晶状体和无晶状体眼中最晚期，青光眼在假晶状体、无晶状体和半脱位晶状体眼中更为明显。结论：在大量CA患者中，既往白内障手术与术后假晶状眼和无晶状眼较高的AAK等级和继发性青光眼相关。我们的数据表明，先天性无虹膜白内障手术需要谨慎。
期刊介绍：
The principal aim of Current Eye Research is to provide rapid publication of full papers, short communications and mini-reviews, all high quality. Current Eye Research publishes articles encompassing all the areas of eye research. Subject areas include the following: clinical research, anatomy, physiology, biophysics, biochemistry, pharmacology, developmental biology, microbiology and immunology.
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