Visual outcomes after paediatric cataract surgery

Session Details

Session Title: Cataract I
Session Date/Time: Friday 26/02/2016 | 10:30-12:30
Paper Time: 11:00
Venue: MC3 Room
First Author: : V.Choleva UK
Co Author(s): :    A. Churchill              

Abstract Details

Purpose:

Paediatric cataract surgery aims either to give the opportunity of visual development during amblyogenic period or to restore good visual function. IOL may be primarily used after lens aspiration or implanted later when the eye development is completed. Visual rehabilitation with spectacles/contact lenses and patching starts immediately after cataract surgery and may last several years. We aim to determine visual outcomes after cataract surgery in children in our Department.

Setting:

13 year survey, Paediatric Department, Bristol Eye Hospital, UK

Methods:

We retrospectively reviewed final visual acuity (VA) in 66 children who underwent surgery for bilateral or unilateral (only operated eye) cataract taking into account the effect of age at surgery, comorbidities and length of follow up. We also recorded final refraction, complications and need for further surgical procedures. We divided all patients in bilateral and unilateral cataract surgery group and then in 4 sub-groups: children undergoing surgery within 8 weeks of life, from 8 weeks to 1 year, from 1 year to 7 years and the last group undergoing surgery after 7 years of age.

Results:

Best-corrected VA was estimated 0.57 ±0.43 in the bilateral group and 0.89±0.51 logMar in the unilateral one. Final refraction was from -3 to +3 spherical equivalent in 67% bilateral and 68% unilateral patients; sub-groups 4 had more predictable post-operative refraction. Visual axis opacification was the most common complication, followed by contact lenses related conjunctivitis/keratitis or pseudophakic/aphakic glaucoma. Interestingly, posterior axis opacification was observed also in eyes undergoing primary posterior capsulorhexis and anterior vitrectomy and one patient required three consecutive surgical capsulotomies. In our review 8.25% of 109 operated eyes developed glaucoma and 4 of them required surgical treatment.

Conclusions:

Management of paediatric cataract surgery is complex and challenging. We found that bilateral cataract patients achieved better final visual acuities than unilateral cataract ones and among the bilateral patients sub-groups 3 and 4 had better visual outcome. There are numerous factors that may influence the visual outcome including: timing of surgery, changing refraction, complications, compliance to amblyopia treatment and finally systemic comorbidities eg developmental delay.

Financial Disclosure:

NONE