Posters

Risk factor outcome and follow up of cataract surgery in children with type 1 diabetes mellitus (T1DM)

Poster Details

First Author: S.Shukla INDIA

Co Author(s):    R. Shukla   M. Khattri   A. Bajpai              

Abstract Details

Purpose:

To evaluate the possible risk factors associated with cataract in Type 1 Diabetes Mellitus children. Like duration of diabetes, HbA1c levels, acute and chronic complications and nutritional factors .This study was also focused on technique of cataract surgery, type of intra ocular lens implanted, Post surgical visual outcome in immediate, short and long term duration.

Setting:

The study was conducted in Tertiary Care Multispeciality hospital in Kanpur, India jointly by the department of Ophthalmology and Endocrinology between January 2005 to January 2019.

Methods:

Number of patients10,Mean Age of surgery 13.7years, Mean age of cataract detection after diagnosis of T1DM 3.7years(1-8years) Mean Current age16.9years and duration of diabetes 10.3years,HbA1c 7.9, Ketoacidosis 6/10, Nephropathy 2/10,Retinopathy 4/10,7/10 were of low socio economic status. Operated both eyes in 9/10, Type of cataract – cortical 6/10, posterior polar 3/10 and hypermature cataract 1/10. Out of 19 Cataract surgeries –7 were SICS, 10underwent Phacoemulsification and MICS was done for 2. Type of Intraocular Lens implanted were Rigid PMMA in 2 Surgeries. Foldable hydrophilic in 6, foldable Hydrophobic IOL in 7, Heparin coated in 2 and Multifocal in 2surgeries.

Results:

1.In all cases Vision Improved in 1-2weeks and remained good in 14 years followup. 2.Usually cataract was soft or cortical. 3.Surgical outcome of phaco surgery and MICS were better in comparison to small Incision Cataract surgery. 4.PCO was not observed in hydrophobic and Multifocal IOLS. It was observed in 1-4years of follow up of cataract surgery in 8 eyes which were treated by Yag Capsulotomy. 5.Usually bilateral,Majority had cataract after 10 years of age. 6.Not linked to microvascular complications. 7.Strongly associated with ketoacidosis. 8.4 Patients over 14 years of followup developed retinopathy.

Conclusions:

Phaco emulsification with hydrophobic IOL and Multifocal IOL implantation showed significantly better visual outcome and minimal PCO. A positive Correlation was observed with diabetic Ketoacidosis and nutritional deficiency .

Financial Disclosure:

receives non-monetary benefits from a competing company