Abstract
Purpose :
To describe diagnostic signs and biometric characteristics for preexisting posterior capsule defects (PPCDs) in congenital cataracts (CCs), and to explore potential predictors for PPCDs.
Methods :
This retrospective study included 81 CC patients aged within 1 year, who underwent bimanual irrigation/aspiration and 2-limbal-port 23G anterior vitrectomy. Three ophthalmologists reviewed a total of 78 videos (3 videos were missing) and agreed on the typical signs in PPCDs. Based on the integrity of posterior capsule, the CC patients were divided into two groups: PPCDs and ones with intact posterior capsule as Age-matched Controls. The biometric parameters, including central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VAD), axial length (AL), mean keratometry, corneal astigmatism (CA), corneal diameter, IOP, pupil diameter, were compared between two groups. Another three cataract surgeons, who were unaware of the situation of posterior capsule, were required to predict the emergence of a PPCD in the 78 CC patients, depending on typical cataract appearance and biometric characteristics.
Results :
The preoperative diagnostic signs of PPCD were summarized as: a demarcated margin, white granules, bubbles, a posterior capsule plaque and/or heterogeneous nuclear opacity. The LT was significantly thinner in PPCDs (2.65mm, QR, 2.36-3.34mm) than in Controls (4.51mm, QR, 3.87-5.00mm) (P < 0.001). The VCD in PPCDs (12.98±1.29 mm) was significantly larger than that in the controls (12.02±1.41mm) (P < 0.001). Corneal diameter was significantly smaller in PPCDs (9.30mm/9.00mm, QR, 9.00-9.90mm/8.50-9.50mm) than in Controls (9.80mm/9.40mm, QR, 9.50-10.00mm/9.00-9.55mm) (P = 0.015 and 0.005, horizontal and vertical, respectively). Multivariate analysis identified LT (OR 0.731, 95% CI 0.621-0.860, P < 0.001) as an independent risk factor for PPCDs. On the basis of diagnostic signs and LT value, the mean accuracy of predicting a PPCD preoperatively was 87.3%.
Conclusions :
A carefully preoperative evaluation and routine biometric measurement is crucial to congenital cataracts, especially in cases of suspecting a PPCD. The LT well complemented preoperative diagnostic signs in predicting a PPCD in congenital cataracts.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.