Posters

Long-term visual outcome after cataract surgery in infants

Poster Details

First Author: L.Sankaranarayanan INDIA

Co Author(s):    P. Krishnan   R. Bhat                 

Abstract Details

Purpose:

Early surgery of congenital cataracts often entail multiple procedures, management of optical correction, occlusion therapy and glaucoma surgery.Often unilateral cataracts managed with contact lenses and patching have poor compliance.Due to the ocular associations, unilateral cataract surgery gives poor visual outcome. Our purpose is to analyse visual outcome after cataract surgery done before the age of one year.

Setting:

Comtrust Charitable Eye Hospital is a 100 bedded tertiary care superspeciality Eye hospital in South India,with all subspecialities and a olume of outpatient more than 1000 daily and with postgraduate training under the National Board of India.

Methods:

A retrospective analysis of 85 eyes of 53 children who were operated for congenital cataract before one year of age either unilaterally or bilaterally during the period from 2001 to 2011,was done.Selected cases of unilateral cataract had primary IOL implantation.They were given optical correction with spectacles in bilateral cases and contact lenses and patching in most of the unilateral cases and followed up every month during the first year and every 3-4 months there after till 4 years .isual acuity was assesed at the end of 5 years. Amblyopia, strabismus,visual axis opacification and glaucoma were managed appropriately.

Results:

There were 29 females and 24 males.There were 21 unilateral cases out of which 4 had IOL implantation as primary procedure.12 case(57%) had persistent hyperplastic primary vitreous(PHPV) ..Out of the bilateral cases the mean VA was logMar 0.4 (ranging from 1.0 to 0.2).Out of 32 bilateral cases,12(37.5%)developed amblyopia and had to institute patching. 8(25%) had surgical correction for strabismus.10 eyes of 5 children were left aphakic. Among unilateral cases, mean VA was logMar0.6(0.3 to 1.5) Cases with primary IOL implants did better. 20eyes(23.5%) had glaucoma surgery within one year after surgery out of which 13(65%)were unilateral cases.

Conclusions:

IOL implantation done judiciously in infants with close follow up give good visual outcome. Compliance in using contact lenses after unilateral surgery is often very poor with long intervals of uncorrected aphakia. Glaucoma is a major complication especially in unilateral cases.Close monitoring for amblyopia even in bilateral cases with good patching regimen give good results in this age group. Full aphakic correction is essential for good visual outcome.

Financial Disclosure:

None