Congenital cataract surgery without intraocular lens implantation in persistent fetal vasculature syndrome: Long-term clinical and functional results

Kuhli-Hattenbach, Claudia; Hofmann, Christian; Wenner, Yaroslava; Koch, Frank; Kohnen, Thomas

doi:10.1016/j.jcrs.2016.02.040

Cited by 15 publications

(12 citation statements)

References 28 publications

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“…Obviously, the risk of terrible complications also depended on the severity of PFV. Kuhli-Hattenbach et al [2] reviewed 19 CC eyes with PFV and recorded the surgical complications including vitreous hemorrhage (52.6%), retinal detachment (15.8%), aphakic glaucoma (10.5%), secondary cataract (10.5%), fibrinous reaction (10.5%), and anterior chamber hemorrhage (5.2%). Compared to PFV, the surgical complications of PCD and PLC were reported relatively slight, including posterior synechiae (3.70%), peripheral anterior synechiae (3.70%), intraoperative posterior capsule tear (3.13%), posterior synechiae (3.13%), VAO (3.13%), and abrupt postoperative increase in IOP (3.13%) [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Persistent fetal vasculature (PFV), posterior capsule defect (PCD), and posterior lenticonus (PLC) are the most common abnormalities of the posterior capsule, which either cause incompletion or permeability transition of the capsule. Several studies [1][2][3] have mentioned the surgical complications in CC eyes with PFV, PCD, or PLC. However, the information given was so limited, and there is still large room for further study because of the great variability of CCs, especially in eyes with PCA.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Surgical Safety in Congenital Cataract Eyes with Three Pathological Types of Posterior Capsule Abnormalities

Ding

Xiang

Wang

et al. 2020

Journal of Ophthalmology

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Purpose. To observe the clinical characteristics of 3 pathological types of posterior capsule abnormalities (PCAs) in congenital cataracts (CCs) and evaluate the surgical safety in these eyes. Methods. This study involved 239 children (367 eyes) with CC who underwent cataract surgery at the Eye Hospital of Wenzhou Medical University. All surgery videos were collected for detailed reviews. Intraoperative and postoperative complications (within 3 months) were all recorded. Results. The 3 pathological types of PCAs, namely, persistent fetal vasculature (PFV), posterior capsule defect (PCD), and posterior lenticonus (PLC), presented in 129 (35.1%) CC eyes, while 238 (64.9%) eyes were recorded as CC without PCA. The percentages of PFV, PCD, and PLC were 10.9%, 26.7%, and 5.4% in CC eyes (n = 367), respectively. The most common concomitant of PFV eyes was PCD (42.5%), and PFV was the most frequent (17.3%) one in PCD eyes. PLC was only associated with PFV (15%) and PCD (50%). The occurrence rates of surgical complications ranged from 0 to 5.4%, and no statistical difference was found between the eyes with and without PCA (all P>0.05). Conclusions. PFV, PCD, and PLC play a very important role in the CCs. The effect of fetal vessels in PFV eyes might be an abnormally strong attachment on the posterior capsule, leading to PLC and PCD. Even in PCA patients, severe surgical complication can also be avoided with well-designed and skilled operation. This trial is registered with NCT03905044 at http://ClinicalTrials.gov.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Surgical Safety in Congenital Cataract Eyes with Three Pathological Types of Posterior Capsule Abnormalities

Ding

Xiang

Wang

et al. 2020

Journal of Ophthalmology

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“…; Kuhli‐Hattenbach et al. ). Additionally, an optic capture technique with implantation of posterior chamber intraocular lenses (IOL) has been implicated in paediatric cataract surgery (Gimbel ).…”

Section: Introductionmentioning

confidence: 99%

“…Still the visual and anatomical outcomes after cataract surgery in this age group are strongly correlated with the aetiology of the cataract, concomitant ocular or/and systemic diseases, age at surgery and postoperative visual rehabilitation (Bradford et al 1994;Eriksen et al 2006;Kirwan & O'Keefe 2006;Birch et al 2009). A conventional lens-in-the-bag technique or lensectomy with postoperative aphakia are the most used surgical approaches (Zetterstrom et al 2005;Haargaard et al 2009;Kim et al 2012;Gupta et al 2014;Kuhli-Hattenbach et al 2016). Additionally, an optic capture technique with implantation of posterior chamber intraocular lenses (IOL) has been implicated in paediatric cataract surgery (Gimbel 1996).…”

Section: Introductionmentioning

confidence: 99%

Analysis and management of intraoperative and early postoperative complications of bag‐in‐the‐lens intraocular lens implantation in different age groups of paediatric cataract patients: report of the Giessen Paediatric Cataract Study Group

Lytvynchuk

Thiele

Lorenz

2019

Acta Ophthalmologica

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Purpose To report the rate and management of intra‐ and early postoperative complications of bag‐in‐the‐lens intraocular lens (IOL) implantation technique for cataract treatment in paediatric patients of different age groups. Settings Department of Ophthalmology, Justus‐Liebig‐University Giessen, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany. Design Retrospective non‐randomized consecutive case series. Methods Ninety eyes of 60 paediatric cataract patients were enrolled to this retrospective non‐randomized observational consecutive case series single‐centre study. All patients underwent cataract surgery with bag‐in‐the‐lens IOL implantation between January 2008 and December 2018, performed by two experienced surgeons. The entire cohort was divided into four age groups: first – 0–<3 months, second – 3–<12 months, third – 12–<36 and fourth – >36 months–17 years of age. The intra‐ and postoperative complications were based on the clinical records. The description of management of complications related specifically to bag‐in‐the‐lens IOL technique was based on the 39 consecutive cases operated since 1 Jan 2016 by one single surgeon that were all video documented. The early postoperative period was defined as 12 months after surgery. Results Overall, there were 27 unilateral and 33 bilateral surgical cases of 24 female and 36 male children. The mean age at surgery was 45.25 months (range 1–200 months). The most common intraoperative events were vitreous prolapse and anterior capsule rupture with 28.9% and 13.3%, respectively. Within 12 months of follow‐up, five eyes (5.6%) were re‐operated because of visual axis reo‐pacification (VAR). Intraocular hypertension was diagnosed in seven eyes (7.8%), including two cases that required surgical treatment. In all cases with intra‐ and early postoperative complications related specifically to bag‐in‐the‐lens technique, it was possible to manage them and successfully implant bag‐in‐the‐lens IOL. Conclusions Implementation of bag‐in‐the‐lens technique in the treatment of paediatric cataract was associated with a relatively low rate of intra‐ and postoperative complications, including rare cases of VAR. The correct management of complications related specifically to bag‐in‐the‐lens IOL implantation technique shall to be considered during the learning curve.

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“…Kuhli-Hattenbach et al (2008) reported that 71.4% of the children who developed glaucoma underwent surgery during their first 3 months of life. Many studies exclude patients with ocular or systemic disease (Solebo et al 2015;Kuhli-Hattenbach et al 2016;Lin et al 2017), and the definition of ocular comorbidity may vary. One of the main findings from our previous study was that the majority of eyes that did develop glaucoma were patients with ocular or systemic disease (Nystrom et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Secondary glaucoma and visual outcome after paediatric cataract surgery with primary bag‐in‐the‐lens intraocular lens

Nyström

Magnusson

Zetterberg

2019

Acta Ophthalmologica

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Purpose: To determine predictors of secondary glaucoma and poor visual outcome in children undergoing cataract surgery with bag-in-the-lens (BIL)-IOL implantation. Methods: Medical records were retrospectively analysed for children with primary implantation with BIL-IOL during 2009-2013. Results: The study included 109 eyes. Median age at surgery was 2.5 years (range 2 weeks-14.1 years), 26.6% being ≤12 weeks of age (= early group). Median follow-up time was 2.8 years (7 months-5.8 years). 15 eyes (13.8%) developed glaucoma, 14 (48.3%) in the early group and 1 (1.3%) in the late group (p < 0.001). Within the early group, mean time for surgery differed significantly. Patients developing glaucoma had cataract surgery at 3.5 AE 1.1 weeks (mean AE SD) and the non-glaucoma patients at 5.7 AE 3.3 weeks (p = 0.024). In the entire cohort, 21 eyes (19.3%) had conditions associated with glaucoma; 57.1% of these developed glaucoma compared to 3.4% without these conditions (p < 0.001). Corrected distance visual acuity (CDVA) (decimal) of ≥0.5 was seen in 50 eyes (48.5%), median 0.63 in the late group and 0.15 in the early group. Glaucoma eyes in the early group (surgery at 3.5 weeks) achieved 0.56 median (range, 0.4-1.0) logMAR, (0.28 decimal) CDVA, whereas non-glaucoma eyes (surgery at 5.7 weeks) achieved 0.89 median (range 0.7-1.6) logMAR (0.13 decimal) CDVA; p = 0.016. Glaucoma development in infants between 5 weeks and 2 years of age was 6.7% (n = 2/30). Conclusions: Comorbidity strongly increases the risk of secondary glaucoma. Surgery during the first month is correlated with better CDVA outcome and glaucoma. After 5 weeks of age, glaucoma rate is low with the BIL-IOL.

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Congenital cataract surgery without intraocular lens implantation in persistent fetal vasculature syndrome: Long-term clinical and functional results

Abstract: None of the authors has a financial or proprietary interest in any material or method mentioned.

Cited by 15 publications

References 28 publications

Clinical Characteristics and Surgical Safety in Congenital Cataract Eyes with Three Pathological Types of Posterior Capsule Abnormalities

Clinical Characteristics and Surgical Safety in Congenital Cataract Eyes with Three Pathological Types of Posterior Capsule Abnormalities

Analysis and management of intraoperative and early postoperative complications of bag‐in‐the‐lens intraocular lens implantation in different age groups of paediatric cataract patients: report of the Giessen Paediatric Cataract Study Group

Secondary glaucoma and visual outcome after paediatric cataract surgery with primary bag‐in‐the‐lens intraocular lens

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