AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with ...AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with uveal coloboma(MCUC),13 patients of microcornea without coloboma(MCNC),and 30 age-matched healthy individuals(the control group).Corneal biometric parameters such as axial length(AL),anterior chamber depth(ACD),and white-to-white corneal diameter(WTW)were measured using the IOL Master.The corneal endothelial cell density(ECD),percentage of hexagonal cells(6A),average cell area(AVE),maximum cell area(MAX),minimum cell area(MIN),cell area standard deviation(SD),and coefficient of variation(CV)were collected by specular microscopy.RESULTS:This study included MCUC and MCNC patients with age-and sex-matched controls.All patients exhibited significantly reduced WTW(MCUC:8.51±0.71 mm;MCNC:9.08±0.42 mm)and worse logMAR BCVA(MCUC 0.62±0.43;MCNC 0.46±0.28)compared to controls(both P<0.001).The ECD was 3106.32±336.80 cells/mm²in the MCUC group and 2906.92±323.53 cells/mm²in the MCNC group,both significantly higher than the control group(2647.43±203.06 cells/mm²,P<0.05).In contrast,the CV,AVE,SD,and ACD in the MCUC and MCNC groups were significantly lower compared to controls(P<0.01).In patients with microcornea,the WTW was negatively correlated with the ECD and 6A,but positively with the CV,MAX,AVE,and SD.The ACD was negatively linked to the ECD,but positively to the AVE.CONCLUSION:The corneal ECD and 6A are increased,while the CV is decreased in patients with microcornea,particularly in those accompanied by uveal coloboma.The ECD and morphology demonstrate close correlations with the WTW and ACD.展开更多
AIM:To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea.METHODS:This retrospective consecutive case series study compared outcomes after congenital cataract su...AIM:To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea.METHODS:This retrospective consecutive case series study compared outcomes after congenital cataract surgery in eyes with/without microcornea.Infants(<1 year old)who underwent lensectomy surgery left aphakic were included.Microphthalmos was defined as an eye that has a horizontal corneal diameter less than or equal to 9.0 mm.RESULTS:There were 40 infants(54 eyes)in the microcornea group and 58(87 eyes)in the control group.The two groups were age-and sex-matched.The microcornea group showed significantly smaller corneal diameter(P<0.001),steeper corneal keratometry(P=0.001),thinner lens thickness(P<0.001),and shorter axial length(AL,P<0.001).And microcornea increased the incidence of poor pupil dilation(P<0.01).The two groups showed no significant differences in postoperative intraocular pressure(IOP),best-corrected visual acuity,central corneal thickness(CCT),AL,and the incidence of strabismus and nystagmus at the last follow-up.CONCLUSION:Although microcornea have different features from normal ones,the one-year follow-up after surgery has shown that early surgical intervention for congenital cataracts in eyes with microcornea can result in favourable outcomes with an acceptable rate of postoperative complications.Regular follow-up and timely management of postoperative complications are crucial for successful outcomes.展开更多
This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthal...This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.展开更多
AIM:To evaluate the graft rejection and visual outcomes after penetrating keratoplasty(PK)in the presence of various congenital corneal opacities in children.METHODS:In this retrospective cohort study,children who und...AIM:To evaluate the graft rejection and visual outcomes after penetrating keratoplasty(PK)in the presence of various congenital corneal opacities in children.METHODS:In this retrospective cohort study,children who underwent PK were then followed for 5 y.The patient’s medical records were collected from June 2014 until June 2019 and analyzed in December 2019.All patients were children under three years old with congenital corneal opacities with or without microcornea who came to a pediatric ophthalmologist and underwent PK in Jakarta Eye Center(JEC).Beforehand,all children have participated in a thorough evaluation for PK.In the case of severe microcornea was not advised to undergo surgery.The visual outcomes and graft survival rate were described in percentages.The graft survival plot was presented with Kaplan-Meier,while the visual acuity was analyzed using the Wilcoxon signed ranks test.RESULTS:Sixteen eyes from eleven patients(seven girls and four boys)underwent PK.The graft survival rate of the first 6,12,and 18 mo later of keratoplasty was 100%,83.3%,and 66.7%,respectively.The overall mean survival time is 22 mo(standard error 2.419),and no significant difference between the patients underwent PK before and after 36 mo of their age(P=0.52).The graft failure was 50%,and postsurgery complications included cataract 43.7%,band keratopathy 12.5%,and scleromalasia 6.25%.Wilcoxon test analysis of visual acuity post keratoplasty was not statistically significant(P=0.34),while overall showed 44%improvements of visual outcome for 5 y of follow-up.With a good survival at one year up to 22 mo(83.3%),the visual acuity could be achieved(63%),and showed improvements(44%)during follow-up.CONCLUSION:The complications are frequent for pediatric PK.Thus,corneal surgery on infants requires careful case selection,adequate pre-operative evaluation,skilled surgery(optical correction),very close cooperation family–physician,intensive post-operation care,and amblyopia management in the future.展开更多
目的：探讨小角膜合并先天性白内障患者的眼部临床表现、手术治疗时机及疗效。 方法：回顾性分析2000-01／2012-12在天津医科大学眼科中心接受治疗的先天性白内障合并小角膜患者11例18眼的临床资料，术前检查包括角膜直径（＜9．5 mm ...目的：探讨小角膜合并先天性白内障患者的眼部临床表现、手术治疗时机及疗效。 方法：回顾性分析2000-01／2012-12在天津医科大学眼科中心接受治疗的先天性白内障合并小角膜患者11例18眼的临床资料，术前检查包括角膜直径（＜9．5 mm ）、眼部异常和全身异常，术后随访至少1a，评价术后视力和并发症等。 结果：患者11例中有先天性白内障家族史4例，18眼中合并虹膜缺损6眼，眼球震颤18眼，原始玻璃体动脉残留1眼。对11例18眼患者施行三种手术方案：（1）行囊外白内障摘除术（ extra capsular extraction of cataract ， ECCE ）者5眼；（2）Ⅰ期行 ECCE ，Ⅱ期行人工晶状体植入术（posterior chamber intraocular lens ，PC-IOL）者4眼；（3）Ⅰ期行ECCE联合PC-IOL植入者9眼。术后患者视力均有明显改善，18眼术后最佳矫正视力0．145＆#177;0．0958（0．01～0．20）。 ECCE术中并发症主要为后囊破裂1眼，术后并发症主要为后发性白内障10眼，继发性青光眼2眼。 结论：先天性白内障合并小角膜常伴发虹膜、脉络膜缺损，眼球震颤等合并症，人工晶状体的植入能明显提高患者视力，但术中应注重防范角膜损伤、后囊破裂等并发症，术后加强管理，特别是眼压的监测，以极早防治青光眼等并发症。展开更多
基金Supported by the National Natural Science Foundation of China(No.82271052No.82201154)+2 种基金Shandong Provincial Key Research and Development Program(No.2024CXGC010617)Taishan Scholar Program(No.tstp20240858)Educational and Teaching Reform Research Project of Shandong First Medical University(No.XM2024001).
文摘AIM:To assess the corneal biometric parameters and endothelial cell characteristics in microcornea patients,and exploring their correlations.METHODS:This cross-sectional study included 28 patients of microcornea with uveal coloboma(MCUC),13 patients of microcornea without coloboma(MCNC),and 30 age-matched healthy individuals(the control group).Corneal biometric parameters such as axial length(AL),anterior chamber depth(ACD),and white-to-white corneal diameter(WTW)were measured using the IOL Master.The corneal endothelial cell density(ECD),percentage of hexagonal cells(6A),average cell area(AVE),maximum cell area(MAX),minimum cell area(MIN),cell area standard deviation(SD),and coefficient of variation(CV)were collected by specular microscopy.RESULTS:This study included MCUC and MCNC patients with age-and sex-matched controls.All patients exhibited significantly reduced WTW(MCUC:8.51±0.71 mm;MCNC:9.08±0.42 mm)and worse logMAR BCVA(MCUC 0.62±0.43;MCNC 0.46±0.28)compared to controls(both P<0.001).The ECD was 3106.32±336.80 cells/mm²in the MCUC group and 2906.92±323.53 cells/mm²in the MCNC group,both significantly higher than the control group(2647.43±203.06 cells/mm²,P<0.05).In contrast,the CV,AVE,SD,and ACD in the MCUC and MCNC groups were significantly lower compared to controls(P<0.01).In patients with microcornea,the WTW was negatively correlated with the ECD and 6A,but positively with the CV,MAX,AVE,and SD.The ACD was negatively linked to the ECD,but positively to the AVE.CONCLUSION:The corneal ECD and 6A are increased,while the CV is decreased in patients with microcornea,particularly in those accompanied by uveal coloboma.The ECD and morphology demonstrate close correlations with the WTW and ACD.
基金Supported by the“Pioneer”and“Leading Goose”R&D Program of Zhejiang(No.2022C03070)Zhejiang Medical and Health Science and Technology Plan(No.2023KY913)+2 种基金the Zhejiang Provincial Program of China for the Cultivation of Health Leading TalentsWenzhou Basic Scientific Research Projects(No.Y20220145)The Science and Technology Program Project jointly built by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine(No.GZY-ZJKJ-24089).
文摘AIM:To find out intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea.METHODS:This retrospective consecutive case series study compared outcomes after congenital cataract surgery in eyes with/without microcornea.Infants(<1 year old)who underwent lensectomy surgery left aphakic were included.Microphthalmos was defined as an eye that has a horizontal corneal diameter less than or equal to 9.0 mm.RESULTS:There were 40 infants(54 eyes)in the microcornea group and 58(87 eyes)in the control group.The two groups were age-and sex-matched.The microcornea group showed significantly smaller corneal diameter(P<0.001),steeper corneal keratometry(P=0.001),thinner lens thickness(P<0.001),and shorter axial length(AL,P<0.001).And microcornea increased the incidence of poor pupil dilation(P<0.01).The two groups showed no significant differences in postoperative intraocular pressure(IOP),best-corrected visual acuity,central corneal thickness(CCT),AL,and the incidence of strabismus and nystagmus at the last follow-up.CONCLUSION:Although microcornea have different features from normal ones,the one-year follow-up after surgery has shown that early surgical intervention for congenital cataracts in eyes with microcornea can result in favourable outcomes with an acceptable rate of postoperative complications.Regular follow-up and timely management of postoperative complications are crucial for successful outcomes.
文摘This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.
文摘AIM:To evaluate the graft rejection and visual outcomes after penetrating keratoplasty(PK)in the presence of various congenital corneal opacities in children.METHODS:In this retrospective cohort study,children who underwent PK were then followed for 5 y.The patient’s medical records were collected from June 2014 until June 2019 and analyzed in December 2019.All patients were children under three years old with congenital corneal opacities with or without microcornea who came to a pediatric ophthalmologist and underwent PK in Jakarta Eye Center(JEC).Beforehand,all children have participated in a thorough evaluation for PK.In the case of severe microcornea was not advised to undergo surgery.The visual outcomes and graft survival rate were described in percentages.The graft survival plot was presented with Kaplan-Meier,while the visual acuity was analyzed using the Wilcoxon signed ranks test.RESULTS:Sixteen eyes from eleven patients(seven girls and four boys)underwent PK.The graft survival rate of the first 6,12,and 18 mo later of keratoplasty was 100%,83.3%,and 66.7%,respectively.The overall mean survival time is 22 mo(standard error 2.419),and no significant difference between the patients underwent PK before and after 36 mo of their age(P=0.52).The graft failure was 50%,and postsurgery complications included cataract 43.7%,band keratopathy 12.5%,and scleromalasia 6.25%.Wilcoxon test analysis of visual acuity post keratoplasty was not statistically significant(P=0.34),while overall showed 44%improvements of visual outcome for 5 y of follow-up.With a good survival at one year up to 22 mo(83.3%),the visual acuity could be achieved(63%),and showed improvements(44%)during follow-up.CONCLUSION:The complications are frequent for pediatric PK.Thus,corneal surgery on infants requires careful case selection,adequate pre-operative evaluation,skilled surgery(optical correction),very close cooperation family–physician,intensive post-operation care,and amblyopia management in the future.
文摘目的：探讨小角膜合并先天性白内障患者的眼部临床表现、手术治疗时机及疗效。 方法：回顾性分析2000-01／2012-12在天津医科大学眼科中心接受治疗的先天性白内障合并小角膜患者11例18眼的临床资料，术前检查包括角膜直径（＜9．5 mm ）、眼部异常和全身异常，术后随访至少1a，评价术后视力和并发症等。 结果：患者11例中有先天性白内障家族史4例，18眼中合并虹膜缺损6眼，眼球震颤18眼，原始玻璃体动脉残留1眼。对11例18眼患者施行三种手术方案：（1）行囊外白内障摘除术（ extra capsular extraction of cataract ， ECCE ）者5眼；（2）Ⅰ期行 ECCE ，Ⅱ期行人工晶状体植入术（posterior chamber intraocular lens ，PC-IOL）者4眼；（3）Ⅰ期行ECCE联合PC-IOL植入者9眼。术后患者视力均有明显改善，18眼术后最佳矫正视力0．145＆#177;0．0958（0．01～0．20）。 ECCE术中并发症主要为后囊破裂1眼，术后并发症主要为后发性白内障10眼，继发性青光眼2眼。 结论：先天性白内障合并小角膜常伴发虹膜、脉络膜缺损，眼球震颤等合并症，人工晶状体的植入能明显提高患者视力，但术中应注重防范角膜损伤、后囊破裂等并发症，术后加强管理，特别是眼压的监测，以极早防治青光眼等并发症。
