Pediatric Cataract Surgery: Baseline Characteristics of a North American Pediatric Eye Disease Registry

Abstract

 

Purpose

 

To describe the characteristics of children younger than 13 years of age undergoing lensectomy surgery in the United States and Canada.

 

Methods

 

Between June 2012 and November 2013, 51 centers enrolled children into a clinical research registry who had undergone primary lens surgery in the preceding 45 days. Data collected at the time of enrollment from medical record review included patient demographics, systemic and ocular conditions, family history, and whether or not an intraocular lens (IOL) was implanted.

 

Results

 

415 children were enrolled; 211 (51%) were female. Race/ethnicity was 244 (59%) white, 65 (16%) African American, 57 (14%) Hispanic, 14 (3%) Asian, 24(6%) mixed/other, and 11(3%) not reported. Surgery was performed at less than 1 year of age in 138 (33%); 1 to <4 years of age in 87 (21%); 4 to <7 years of age in 94 (23%); and 7 to <13 years of age in 96 (23%). Cataract surgeries were bilateral in 111 (27%). At the time of surgery, a wide range of systemic medical conditions were reported for 119 (29%); developmental delay in 31 (7%) and Down syndrome in 6 (1%). Prior use of oral steroids was reported in 20 (5%). A family history of juvenile cataract was present in 74 (18%). Healthcare insurance was reported for 407 (98%); 46% had Medicaid/State CHIP coverage. The parents of 337 (81%) indicated they were at least high school graduates. Strabismus was present in 107 (26%). Ocular abnormalities other than cataract were present in 123 (24%) of 515 enrolled eyes. Of these abnormalities, 60 (49%) were in the anterior segment only, 39 (32%) were in the posterior segment only, and 24 (20%) occurred in both segments. An IOL was used for 203 of 304 (67%) unilateral cases (Figure top) and 54 of 111 (49%) bilateral cases (Figure bottom) for the entire cohort. IOLs were placed in 7% of cases performed prior to 1 year of age, more often with unilateral surgery than bilateral surgery (12% and 3%, respectively). For children at least1 year of age, IOL implantation was performed in the majority for both unilateral and bilateral surgery (88% and 92%, respectively).

 

Conclusions

 

A minority of children undergoing lensectomy surgery have systemic or ocular conditions associated with their cataract. IOL placement is common after 1 year of age for both unilateral and bilateral lens surgery.

 

 

Unilateral Surgery

 

 

Bilateral Surgery

 

Keywords: 445 cataract • 464 clinical (human) or epidemiologic studies: risk factor assessment • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials