Posters

Surgical challenges of congenital rubella cataract

Poster Details

First Author: L.Sankaranarayanan INDIA

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

Abstract Details

Purpose:

Congenital Rubella accounts for 25% of cataract presenting at birth in South India.Often associated microphthalmos, miotic pupil with poor dialatation, iris abnormalities, glaucoma, may all be associated.Purpose is to analyse the surgical challenges and the visual outcome in congenital rubella cataract.

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 retrospectvie analysis of cases of congenital Rubella proven serologically was done during the period of 2004 to 2014. 49 eyes of 29 infants had surgery during the period between 6 weeks to 4 months.9 were unilateral.They were followed up for glaucoma and fundus examination with aphakic correction every month during the first year and every 3months there after.

Results:

43 eyes had surgery within 8 weeks of birth.3 children were sick and their surgery postponed awaiting cardiac surgery for 3 months .Out of 49 eyes, 26(51%) were microphthalmic. In 13 eyes pupils were miotic with posterior synechieae and in 5 eyes iris hook had to be used for visualisation. Anterior capsulorhexis was done by vitrectorhexis in 11 eyes.During follow up, 12 eyes developed glaucoma and were operated---5 trabeculectomy with mitomycin, 7 with Ahmed valve during the first year. 6 eyes had membranectomy for visual axis opacification.The mean best corrected visual acuity was logMar 0.6(0.4 to 1.5)

Conclusions:

Congenital Rubella Cataract poses special challenges during surgery and follow up.Meticulous cortical clean up is necessary to prevent visual axis opacification.Close monitoring for glaucoma and visual axis opacification are essential. They may need multiple procedures and a good anaesthesia back up is mandatory.

Financial Disclosure:

None