Abstract
Purpose: :
Patients with bilateral cataracts may be treated with bilateral simultaneous (BSI) or bilateral sequential (BSEQ) surgery. The risk of bilateral simultaneous and devastating complications such as endophthalmitis is of concern in BSI. The purpose of this study is to describe the incidence of intraoperative complications occurring in infants who underwent BSI, BSEQ, or unilateral cataract surgery.
Methods: :
We reviewed the medical records of infants at Cincinnati Children’s Hospital Medical Center who had undergone primary BSI, BSEQ, or unilateral cataract extraction at less than 12 months of age between 2002 and 2011. BSEQ surgery was performed 1 week apart. BSI surgery was performed with separate sterile drapes, instruments, gloves, and gowns. Postoperative antibiotic, steroid, and cycloplegic eye drops were prescribed in all patients.
Results: :
Twenty-five infants (41 eyes) met inclusion criteria. Of these, 11 infants (22 eyes), 5 infants (10 eyes), and 9 infants (9 eyes) underwent BSI, BSEQ, and unilateral cataract surgery. No eyes developed endophthalmitis. Both eyes of a single BSI patient, no eyes of 5 BSEQ patients, and 1 eye each of 2 unilateral patients developed pupillary block glaucoma and required subsequent repeat anterior vitrectomy, peripheral iridectomy and goniosynechialysis. Fisher’s exact test showed no statistically significant difference in the incidence of pupillary block glaucoma among the 3 groups on a per infant basis (p = 0.78).
Conclusions: :
Bilateral pupillary block glaucoma occurring in infants undergoing BSI has not previously been reported. However, there was no statistically significant difference in the incidence of pupillary block between BSI, BSEQ, or unilateral cataract surgery groups. Nevertheless, the potential for serious postsurgical complications other than endophthalmitis in patients undergoing cataract extraction needs to be considered when performing BSI surgery.
Keywords: cataract • treatment outcomes of cataract surgery