Abstract
Purpose :
Pediatric cataracts remain a challenge throughout all ages. The post-operative management after pediatric cataract surgery continues to be challenging. Advancement in surgical techniques and better long-term post-operative care have improved these outcomes, but there is still more to learn. We performed a retrospective chart review of pediatric cataract surgery outcomes over an 11-year period in an urban inner-city hospital. The goal of our study was to further understand the post-operative outcomes and compare our results to the current literature.
Methods :
Data was initially collected from 21 patient charts which accounted for 35 eyes. Inclusion criteria required eyes to have a congenital cataract that was not associated with either trauma or previous ocular disorders or surgery and had postoperative follow up for a minimum of 6 months. Of those 35 eyes identified during the chart review, 32 met our inclusion criteria. Subgroups were stratified based on age at time of surgery (infantile ≤18months, Juvenile >18months), unilateral or bilateral cataracts, and aphakic or pseudophakic. Average follow up was for 30 months (2.5 years) with a range of follow up from 6 months to 11 years. Statistical analysis for each group was performed using fisher exact test with an α of 0.05.
Results :
Incidence of glaucoma was significantly higher in the group with infantile cataract (50% (6/12)) compared to the juvenile group (0% (0/20), p=0.001) and in the aphakic group (35% (6/17)) compared to the pseudophakic group (0% (0/15) p= 0.0192). Posterior capsular opacity (PCO) was significantly greater in the juvenile group (50% (10/20)) than in the infantile cataract group (8.3% (1/12), p=0.0232). In the latter group 11 were left aphakic due to the young age and underwent both primary posterior capsulotomy and anterior vitrectomy at the time of the cataract surgery.
Conclusions :
We found that children with infantile cataract were associated with a higher incidence of glaucoma. While aphakia was associated with a greater incidence of glaucoma, we believe that children with infantile cataract often have other associated congenital anterior segment anomaly, which may be more influential in the development of glaucoma. PCO was found to occur more frequently in the juvenile group because all of these eyes had their posterior capsule left intact to support intraocular lens implant. Our findings were consistent with the literature.
This is a 2021 ARVO Annual Meeting abstract.