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SABINE DERRIEN; Visual outcomes in children after congenital cataract surgery with implants before the age of 1 year.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):658.
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© ARVO (1962-2015); The Authors (2016-present)
Congenital cataract is the first cause of treatable blindness in children. The implantation can correct aphakia, reduce compliance issues related to contact lens wear and increase the chances of amblyopia's success rehabilitation. It is still controversial within 1 year. The purpose of this study was to evaluate the visual prognosis and refractive changes in children less than one year operated for unilateral or bilateral congenital cataract with implantation.
Retrospective study of children under the age of one year old operated on for cataract with implantation between 2003 and 2011. The data collected were age at time of surgery, anatomy cataract, associated diseases, complications, visual acuity and refractive development.
We included 167 eyes of 103 patients (39 unilateral and 64 bilateral cataracts, average age 5 months). Nuclear cataract was predominant. The main diseases associated were microphthalmia (4.8%), persistent fetal vasculature (10.2%) and a general neurological pathology (14.4%). The most common early complications were posterior capsule opacification (25% of the eyes) and late complications are hypertonia and glaucoma (10% of eyes). The final median visual acuity was 20/40 with a statistically significant improvement over time (p <0.05). There was a significant difference in final visual acuity between the uni and bilateral cataracts. Complicated glaucoma and strong refractive errors had a statistically lower final visual acuity.
Primary implantation during cataract surgery within the first year of life remains controversial due to the high incidence of secondary proliferation, to the unpredictability of ocular growth and to the long-term refraction. Primary implantation appears effective in the treatment of congenital cataract in children under one year.
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