Safety and outcomes of paediatric cataract surgery

Session Details

Session Title: Paediatric Ophthalmology & Other Topics

Session Date/Time: Tuesday 25/09/2018 | 08:00-10:30

Paper Time: 08:36

Venue: Room A3, Podium 2

First Author: : J.Neffendorf UK

Co Author(s): :    E. Hawkes   V. Sandford   D. Hildebrand              

Abstract Details

Purpose:

Paediatric cataract surgery is a complex procedure with multiple surgical risks and potential post-operative complications. Visual axis obscuration can be a particular problem, requiring simultaneous posterior capsulotomy and anterior vitrectomy at the time of surgery. Various lens positions have been advocated to try and maximise visual potential and reduce the need for re-operation. Furthermore, the rate of glaucoma post-operatively is estimated as high as 30%. We report our paediatric cataract surgery outcomes with particular reference to visual axis obscuration and glaucoma rate.

Setting:

All cataract procedures were performed by the same surgeon at two hospitals in the UK (John Radcliffe Hospital, Oxford and Royal Berkshire Hospital, Reading).

Methods:

A retrospective analysis of aetiology, change in best corrected visual acuity (BCVA), re-operation frequency and complication rate was performed. Sub-group analysis was performed on cases undergoing intra-ocular lens (IOL) positioning by optic capture with particular emphasis on post-operative visual axis obscuration rate.

Results:

Average age at time of surgery was 60.3 months (range: 1-190 months). An IOL was inserted at the time of lens aspiration in 75% of cases (36/48). 50% (18/36) of those undergoing primary IOL implantation had optic capture through both anterior and posterior capsulotomies. Mean BCVA in optic capture cases improved from 1.38 to 0.40 logMAR at mean follow-up of 23 months. Only 1/18 (5.6%) optic capture cases required further surgery, to clear proliferating Elschnig pearls. The overall incidence of glaucoma was 8.3% (4/48) with none requiring trabeculectomy or tube procedure. There were no cases of endophthalmitis or retinal detachment

Conclusions:

We demonstrate the general operative and post-operative safety and efficacy of the optic capture technique. Secondary glaucoma in this study was infrequent and did not require any filtering or tube surgery. The optic capture technique was associated with a very low re-operation rate of 5.6%.

Financial Disclosure:

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