Posters

Retrospective evaluation of simultaneous bilateral paediatric and juvenile cataract surgery: 15 years' experience

Poster Details

First Author: K.Eibenberger AUSTRIA

Co Author(s):    E. Stifter   F. Pusch   U. Schmidt-Erfurth              

Abstract Details

Purpose:

The main purpose of the study was to evaluate the safety and management of simultaneous bilateral pediatric cataract surgery (BS-CAT) compared to unilateral cataract surgery (US-CAT) and bilateral cataract surgery at two separate days (BT-CAT). Another aim was to assess the postoperative complications.

Setting:

This retrospective case study included children age 0 to 18 years who received cataract extraction due to a uni- or bilateral cataract between January 2003 and December 2018. Inclusion comprised of congenital or juvenile cataract as well as cataract associated with persistent hyperplastic primary vitreous (PHPV).

Methods:

220 eyes of 174 patients were included in this analysis. The US-CAT group comprised of 74 eyes of 74 patients with a mean age of 16±27 months and the BS-CAT group of 126 eyes of 63 patients with mean age of 33±58months. The BT-CAT group included 20 eyes of 10 patients with a mean age of 41±55months. Information regarding type and duration of surgery, and total anesthesia time (intubation to extubation; BT-CAT: time of anesthesia for both surgery was added together) were recorded. Additionally, postoperative complications including re-treatments were recorded.

Results:

Lensectomy combined with anterior vitrectomy was the main surgical approach in all groups (US-CAT:96%; BS-CAT:91%; BT-CAT:90%;p=0.26). Mean anesthesia time was shortest in the US-CAT (92±26min) followed by the BS-CAT (124±30min) and BT-CAT group (186±42min;p>0.001), in contrast to the duration of surgery (US-CAT:37±16min; BS-CAT:31±17min; BT-CAT:37±19;p=0.087). The number of postoperative interventions were similar in all groups (US-CAT:0.57±0.94; BS-CAT:0.79±1.6; BT-CAT:0.47±1.3; p=0.43). Nystagmus and aphakic glaucoma were more pronounced in bilateral (nystagmus: B-CAT:50%, BT-CAT:22%; glaucoma: BS-CAT:15%, BT-CAT:28%) compared to unilateral cataract (nystagmus:13%; p<0.001; glaucoma:7%;p<0.001), whereas strabismus vice versa (US-CAT:75%; BS-CAT:34%; BT-CAT:54%;p<0.001).

Conclusions:

Simultaneous removal of bilateral cataract in children is a safe method compared to unilateral as well as two-timed bilateral cataract surgery, since no rise of postoperative interventions was observed. Lensectomy with anterior vitrectomy was the main surgical approach in all groups. Anesthesia time was increased in simultaneous bilateral compared to unilateral cataract surgery.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company