Bilateral congenital and developmental cataract surgery outcomes in eyes with and without microcornea

Session Details

Session Title: Congenital Cataract Surgery

Session Date/Time: Sunday 14/09/2014 | 16:30-18:30

Paper Time: 16:36

Venue: Boulevard A

First Author: : N.Solmaz TURKEY

Co Author(s): :    F. Önder   G. Koca           

Abstract Details

Purpose:

To investigate in cases with congenital and developmental cataract the effects of the presence of microcornea on visual outcomes and complications.

Setting:

Department of Ophthalmology, Haseki Training and Research Hospital, Istanbul, Turkey

Methods:

The records of the patients operated between 1998 and 2012 for bilateral congenital and developmental cataract were review retrospectively. Forty-six cases ( 12 years or younger at the time of surgery ) with minimally one-year post-operative follow up were included in the study. Those cases with micropthalmia, persistent fetal vasculature (PFV) and congenital glaucoma were excluded. The selected cases were divided into two groups with and without microcornea and were compared on the bases of age at the primary surgery, presence of ocular and systemic anomalies, intraocular lens implantation, visual outcomes and complications using the Mann-Whitney U Test, taking the p < 0.05 value as statistically significant.

Results:

Group I consisted of the 30 eyes of 15 cases with microcornea, while 62 eyes of the 31 cases with normal corneal diameter made up group II. In cases with microcornea the corneal diameter varied between 8 and 10 mm. Statistically significant difference was not found between group I and group II with regard to the age at surgery ( 26.2±31.4 vs 34.4±41.8 months, respectively ) and the follow up period ( 77.2±56.5 vs 53.2±35.7 months, respectively ). The incidence of systemic pathology was not different in the two groups. Nystagmus was present in 67% of the group I and 32% of the group II cases (p<0.001); and, while 60 % of the group I cases were aphakic, 80% of the group II cases were pseudophakic (p<0.005). The mean best corrected visual acuity (BCVA) was 1.0±0.7 logMAR and 0.75±0.9 logMAR in the group I and group II, respectively (p<0.05). About 60 % of the cases in group II and only 25 % of the cases in group I had 0.3 logMAR or good BCVA. The most important complication was secondary glaucoma and it was observed in 36% of group I and 19.5% of the group II cases (p<0.05).

Conclusions:

High incidence of nystagmus in patients with microcornea is restrictive to restoration of visual acuity and leaving most of the cases aphakic complicates visual rehabilitation. Also, the increased risk of secondary glaucoma threatens vision in the long term, therefore requiring lifelong close follow up of the patient.

Financial Interest:

NONE