医学
早产儿视网膜病变
眼科
人工晶状体
白内障手术
后囊膜混浊
外科
视力
超声乳化术
胎龄
怀孕
遗传学
生物
作者
Murugesan Vanathi,Devesh Kumawat,Rashmi Singh,Parijat Chandra
出处
期刊:Journal of Pediatric Ophthalmology & Strabismus
[SLACK, Inc.]
日期:2019-05-22
卷期号:56 (3): 162-167
被引量:7
标识
DOI:10.3928/01913913-20190211-02
摘要
Purpose: To report the occurrence of lens injury during intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in infants with retinopathy of prematurity (ROP). Methods: ROP cases presenting to a tertiary care center with cataract following intravitreal injection were retrospectively studied from June 2017 to May 2018. The indication, setting, and method of injection were noted. Ultrasound biomicroscopy (UBM) details were recorded. The main measures were morphology of cataract, posterior capsular defect, and intraocular lens (IOL) placement. Results: Three children (mean age: 14 ± 8.6 months, two male and one female) received injection elsewhere under topical anesthesia in the neonatal intensive care unit (NICU) for type 1 ROP (stage 3 in zone I or II with significant plus disease) 9 to 18 months earlier. All cases developed cataract caused by intravitreal needle damaging the posterior capsule. In one case, a dense zonular cataract was present and peripheral dehiscence of the posterior capsule became evident only during lens aspiration. The second and third cases had a central posterior subcapsular cataract. Preexisting central dehiscence of the posterior capsule was noted on UBM and confirmed during surgery. A multi-piece IOL was securely placed in all cases. At last follow-up (median: 6 months; range: 3 to 6 months), the IOL was stable and centered in all cases with a clear visual axis. Conclusions: The increasing occurrence of cataract in treatment-requiring ROP following intravitreal anti-VEGF injections being given by practitioners in the NICU setting under topical anesthesia that hinders optimal visualization and technique is a significant concern. [ J Pediatr Ophthalmol Strabismus . 2019;56(3):162–167.]
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