Congenital cataract surgery with intraocular lens implantation in microphthalmic eyes: visual outcomes and complications

Abstract

This study was approved by the Ethics Committee of the Fundação Altino Ventura (Protocol 071/09). ABSTRACTPurpose: To report the visual outcomes and complications of congenital cataract surgery with primary intraocular lens implantation in microphthalmic eyes of children younger than 4 years of age. Methods: This retrospective interventional case series included 14 microphthalmic eyes from 10 children who underwent congenital cataract surgery with primary intraocular lens implantation younger than 4 years of age. Seven patients had bilateral cataracts (11 eyes met the study's inclusion criteria) and 3 patients had unilateral cataract. Patients' medical charts were reviewed to obtain information regarding the preoperative and postoperative ophthalmological examination. Main outcome measures were intraocular pressure (IOP), bestcorrected visual acuity, and intraoperative and postoperative complications. Results: Mean age at the time of surgery was 21.7 ± 2.9 months. Mean ocular axial length was 19.2 ± 0.9 mm. Mean preoperative IOP was 9.7 ± 1.7 mmHg and 10.3 ± 3.1 mmHg on final followup (P=0.18). There were no intraoperative com plications. Two (15.4%) eyes developed secondary visual axis opacification, of which only one needed to be reoperated due to significantly decreased vision (0.5 logMAR). Preoperative and postoperative bestcorrected visual acuity was 2.09 ± 0.97 logMAR and 0.38 ± 0.08 logMAR in bilateral cases and 1.83 ± 1.04 logMAR and 0.42 ± 0.13 logMAR in unilateral cases, respectively. Conclusion: Primary intraocular lens implantation in congenital cataract sur gery in microphthalmic eyes resulted in a significant bestcorrected visual acuity im provement with no intraoperative complications and minimal postoperative com plications. Keywords

Postoperative complications and axial length growth after bilateral congenital cataract surgery: eyes with microphthalmos compared to a comparison group

“…The visual acuity results of the microphthalmos group in our study were satisfactory and similar to those of the comparison group. Previous studies reported similar results [17,19,51]. Despite the increased risk of complications that threaten visual function after surgery, we believe that infants with congenital cataracts and microphthalmos will still benefit from early surgical intervention based on a timely and accurate postoperative optical correction.…”

Postoperative Complications and Axial Length Growth after Bilateral Congenital Cataract Surgery: Eyes with Microphthalmos Compared to a Comparison Group

“…Previous studies reported similar results. 21,22,47 Despite the increased risk of complications that threaten visual function after surgery, we believe that infants with congenital cataracts and microphthalmos will still bene t from early surgical intervention based on a timely and accurate postoperative optical correction.…”

Cataract surgery contributes to ocular axis growth of aphakic eyes in infants with complex microphthalmos

“…Some cases may also have posterior capsule defects under dense nuclear opacity of the lens. [ 23 ] Thus, careful operation is required when performing hydrodissection and aspirating lens substance, thus preventing decrease of intraocular flow, sudden increase of IOP, and expansion of posterior capsule defect. [ 24 ] Secondary glaucoma is a common complication among infants undergoing cataract surgery; the onset of glaucoma should range from 10 days to 16.8 years after surgery, and the incidence is as high as 50%.…”