Postoperative complications in bilateral aphakia versus bilateral pseudophakia 5 years following cataract surgery: randomised clinical trial

Session Details

Session Title: Congenital Cataract Surgery

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

Paper Time: 18:03

Venue: Boulevard A

First Author: : A.Vasavada INDIA

Co Author(s): :    S. Vasavada   V. Vasavada   S. Shah   M. Praveen   V. Vasavada   R. Trivedi

Abstract Details

Purpose:

A comparative evaluation of adverse events of bilateral congenital cataract surgery in children younger than 2 years of age with and without intraocular lens (IOL) implantation with a minimum of 5 years follow-up

Setting:

Iladevi Cataract & IOL Research Centre, Raghudeep Eye Hospital, Gurukul Road, Memnagar, Ahmedabad

Methods:

Randomized clinical trial of 60 children undergoing bilateral congenital cataract surgery randomized to:primary aphakia(n=30)or primary IOL implantation(n=30).Surgical technique identical in all eyes except IOL implantation.In aphakics,+25.0Dcontact lenses prescribed on day 1.Trial with aphakic spectacles was mandated.Followup was 1 week,1 month,every 3months during first year,6monthly thereafter upto 5years.At each follow-up,glaucoma, corneal clarity,peripheral anterior and posterior synechiae,IOL centration,visual axis obscuration(VAO),and cell deposits were noted under anesthesia.Change in visual acuity was assessed from preoperatively to 5 year postoperative followup.

Results:

Median age of the patients at time of surgery was 5.41 months(Aphakia), and 5.69 months(Pseudophakia)(P=0.56,Mann-WhitneyTest).5 years postoperatively,more number of aphakic eyes developed glaucoma(16.7%) compared to pseudophakia(11.7%);however,difference was not statistically significantly different (P=0.43).Incidence of posterior synechiae was significantly more in pseudophakia group(29% eyes) compared to aphakia group(3% eyes)(P<0.0001).In pseudophakia group,40% eyes developed cell deposits.VAO was less in aphakia group(7%) compared to pseudophakia group (10%)(P=0.51).Change in visual acuity from preoperatively to final followup was significantly better in pseudophakic group as compared to aphakia group

Conclusions:

More number of aphakic eyes developed glaucoma,although difference was not statistically significant.VAO was not significantly different between groups.IOL implantation achieved better visual outcome.Results of this randomized clinical trial 5 years following surgery showed a similar incidence of serious complications and better visual outcomes in pseudophakic eyes compared to aphakic eyes

Financial Interest:

NONE