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Omar Hassan, Mehmet Cem Mocan, Aisha Traish; Evaluation of clinical factors related to amblyopia treatment that influence visual outcomes following cataract extraction in pediatric patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4126.
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© ARVO (1962-2015); The Authors (2016-present)
Visual rehabilitation is difficult in pediatric eyes following cataract extraction (CE) and factors that influence visual outcomes are not clearly determined. The purpose of this study was to evaluate the response of amblyopia treatment in pediatric eyes that underwent CE and identify any eye or treatment related factors that had impact on visual acuity.
Retrospective, observational study undertaken at a university clinic. Subjects who underwent CE for either congenital (CC) or acquired (AC) cataracts and who received amblyopia treatment in the form of either part-time occlusion or atropine penalization were included. For each patient, time lag between CE and initiation of amblyopia treatment, duration of and response to amblyopia treatment, final visual acuity in logMAR, and the need for secondary procedures to clear visual axis were determined. The response to amblyopia treatment was compared between patients who underwent CE for CC versus AC. Student’s t-test was used in statistical comparisons.
The mean age of patients at time of CE was similar between the CC (n=14) and the AC (n=11) groups (5.1±3.1 years vs. 4.7±2.2 years; p=0.727). The time lag between surgery and initiation of amblyopia therapy was 5.6±11.6 months in the CC group versus 3.2±1.5 months in the AC group (p=0.456). Compliance with treatment was similar in both groups (71.4% vs. 72.7%;p=0.946). The mean final visual acuity in the CC group was significantly lower (1.15±0.64) as opposed to that of the AC group (0.58±0.48) (p=0.040). The proportion of patients in each group that responded to amblyopia treatment was similar (63.6% vs. 62.5%; p=0.960). Additional procedures were required to clear the visual axis in 42.9% of patients in the CC group as compared to 72.7% in the AC group (p=0.136). Age at CE was the only identified clinical factor that correlated with the final visual acuity (r=-0.551; p=0.010). A need for secondary procedures also appeared to adversely affect visual outcomes (p=0.071).
Amblyopia treatment provides improvement in visual function in subjects with both congenital and acquired cataracts. The age at CE and nature of cataracts appear to be significant prognostic factors that impact eventual visual outcomes in this population.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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