Reports：Association between Aphakia and Endophthalmitis after Pediatric Cataract Surgery

Ophthalmology Volume 130, Number 5, May 2023

中文摘要

本研究探討了小兒白內障手術後眼內炎的相關因素，特別是無晶狀體狀態（Aphakia）。眼內炎是白內障手術後罕見但毀滅性的併發症，其在兒童中的發生率遠高於成人。此項研究使用了大型索賠數據庫，並發現，患有眼內炎的病患更有可能有無晶狀體或創傷的病史。在年齡小於1歲且無晶狀體的患者中，眼內炎的概率更高。無晶狀體與網膜脫落、玻璃體出血、傷口修復和secondary IOL implantation等有顯著關聯，其中，玻璃體出血和網膜脫落與眼內炎有關。總的來說，無晶狀體可被視為年長兒童內眼炎的獨立預測因素。

另一研究描述了由凝膠彈射物引起的眼傷的案例。凝膠彈射物可以導致嚴重的視覺損傷，可能需要進行手術治療，尤其是在前房出血情況下無法控制眼壓的情況。雖然大部分患者在最後恢復到20/20或20/25的視力，但他們可能仍面臨終身的眼部併發症如青光眼的風險。

English Abstract

This study aimed to identify factors associated with endophthalmitis, a severe but rare complication of pediatric cataract surgery. Utilizing a large claims database, the IBM MarketScan Research Database, it was found that children have a significantly higher incidence of endophthalmitis compared to adults. The study also revealed a strong association between aphakia (absence of the lens in the eye) and endophthalmitis in children aged 1 year or younger. Other associated factors include a history of trauma, retinal detachment, vitreous hemorrhage, wound revision, and secondary intraocular lenses. However, the study doesn’t imply that intraocular lenses are protective against endophthalmitis.

In a separate retrospective case series, the study looked at ocular injuries resulting from gel pellet projectiles fired from gel blaster guns. It was found that these injuries can result in severe visual impairment and may require surgical intervention, especially in the case of uncontrolled intraocular pressure due to hyphema. While most eyes recovered to 20/20 or 20/25 vision, they remain at risk for lifelong ocular complications due to the increased risk of traumatic glaucoma.