NR 5/2003
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Wszczepy soczewek heparynizowanych u dzieci we
wczesnym i późnym okresie obserwacji
Heparin-surface-modified PMMA intraocular lenses
in children in early and long-term follow-up
Bronisława Koraszewska-Matuszewska, Elżbieta Samochowiec-Donocik,
Ewa Pieczara, Erita Filipek
Katedra i Klinika Okulistyki Dziecięcej Śląskiej Akademii Medycznej w Katowicach
Kierownik: prof. dr hab. n. med. Bronisława Koraszewska-Matuszewska |
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| Summary: |
Purpose: to compare anatomical and
functional state of eyeballs after congenital cataract extraction and
heparin-surface-modified PMMA (HSM-PMMA) or PMMA implanted lenses and to conclude, which
type of implants is more advantageous in young patients.
Materials and methods: 42 eyes of 30 children at the age of 3 - 16
years with congenital or developmental cataract after extraction and IOL implantation: I
group - HSM-PMMA lenses in 24 eyes, and PMMA lenses in 18 eyes - II group. Mean age in
the I group was 6 years and in the II group 8 years, p = 0,07. The presence of cellular
and pigment deposits on the IOL surface as a sign of postoperative inflammation was
examined by slit-lamp within 1 month after surgery. We have compared the results of visual
acuity (V/A), corneal endothelium cell density and posterior capsule state. The
examinations were done in the short-term follow-up mean 14,1 months (4-24 months) in the I
group and mean 32,1 months (16-48 months) in the II group. In the long-term follow-up mean
38 months (30-44 months) in the I group, and mean 56,1 months (40-72 months) in the II
group.
Results: within first month after operation cellular and pigment deposits
on the IOL surface were seen more often in the II group, p = 0,03. Best corrected V/A was
comparable in both groups in the short-term and the long-term followup. At last visit,
mean value of V/A was 0,54 (I group) and 0,42 (II group), p = 0,37. There was no
significant difference between central corneal endothelial cell density in both groups:
before (2893 ? 261/mm2 and 2821 ? 217/mm2, p = 0,143) and after operation (2371 ?
202/mm2 and 2361 ? 299/mm2, p = 0,428). In the short-term follow-up, but not longer than
within first 12 months after surgery the frequency of clinically significant posterior
capsule opacification (PCO) was less in the HSM-PMMA group (8%), than in the PMMA group
(33%), p = 0,006. In the long-term follow-up there was no statistically significant
difference in PCO appearance between these groups (44% and 50%, p = 0,27).
Conclusions: Heparin-surface-modified intraocular lenses reduced
postoperative inflammation and delayed the incidence of PCO in children.
Heparin-surface-modified intraocular lenses are more advantageous, than PMMA lenses in
young patients. |
| Słowa kluczowe: |
soczewki wewnątrzgałkowe heparynizowane, dzieci, zaćma
wrodzona, zmętnienie tylnej torebki soczewki, śródbłonek rogówki |
| Key words: |
heparin surface modified intraocular lenses, children,
congenital cataract, posterior capsule opacification, corneal endothelium |
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