Incidence, Risk Factors, and Outcomes of Retinal Detachment after Pediatric Cataract Surgery

Agarkar, Sumita; Gokhale, Varada Vinay; Raman, Rajiv; Bhende, Muna; Swaminathan, Gayathri; Jain, Mukesh

doi:10.1016/j.ophtha.2017.07.003

Cited by 41 publications

(67 citation statements)

References 32 publications

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“…; Agarkar et al. ). Postoperative posterior capsular opacification and visual axis re‐opacification (VAR) in cases of lens‐in‐the‐bag with or without posterior capsulorhexis belong to the most frequent complications (Tassignon et al.…”

Section: Introductionmentioning

confidence: 99%

“…One of the main challenges of postoperative pseudophakia and aphakia management is adequate postoperative visual rehabilitation that defines the further development or restoration of visual functions (Bradford et al 1994;Eriksen et al 2006). Intra-and postoperative complications related to cataract surgery, such as posterior capsular opacification, ocular hypertension, uveitis and retinal detachment, play an important role to reach best possible anatomical and functional results (Gradin & Mundia 2011;Vasavada et al 2011;Freedman et al 2015;Agarkar et al 2017). Postoperative posterior capsular opacification and visual axis re-opacification (VAR) in cases of lens-in-the-bag with or without posterior capsulorhexis belong to the most frequent complications (Tassignon et al 1996;Hosal & Biglan 2002).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductionmentioning

confidence: 99%

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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“…Similarly, there have been limited data on the surgical outcomes of rhegmatogenous retinal detachment related to pediatric cataract surgery. In this issue of Ophthalmology, Agarkar et al 5 (see page 36) examined 481 consecutive cases of cataract surgery with primary intraocular lens implantation in 295 children with no other predisposing ophthalmic or systemic anomalies to determine the incidence and risk factors associated with postoperative retinal detachment and to study the outcomes of retinal detachment repair.…”

mentioning

confidence: 99%

“…Eyes of children with intellectual disability had a 37.5% risk of retinal detachment at 10 years after cataract surgery, compared with a 3.2% risk in eyes of children with no intellectual disability. Agarkar et al 5 suggest that children with intellectual disability may be at increased risk of pseudophakic retinal detachment because of excessive rubbing and inadvertent trauma. The cumulative risk of retinal detachment at 10 years was 8.8% in eyes of children with myopia (based on ageadjusted axial length difference <À1 mm) compared with 2.1% in eyes of children with hypermetropia (ageadjusted axial length difference, >0 mm).…”

mentioning

confidence: 99%

“…Agarkar et al 5 report that axial myopia is a significant risk factor for retinal detachment after pediatric cataract surgery. Prior studies of myopia as a risk factor for retinal detachment after cataract extraction in children have used refractive error as a proxy for axial length, 13 but this is of limited value in eyes with abnormally steep or flat keratometry readings.…”

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confidence: 99%

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Rhegmatogenous Retinal Detachment after Pediatric Cataract Surgery

Huerta

Williams

2018

Ophthalmology

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Complications Occurring Through 5 Years Following Primary Intraocular Lens Implantation for Pediatric Cataract

et al. 2023

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ImportanceLensectomy with primary intraocular lens (IOL) implantation is often used in the management of nontraumatic pediatric cataract, but long-term data evaluating the association of age and IOL location with the incidence of complications are limited.ObjectiveTo describe the incidence of complications and additional eye surgeries through 5 years following pediatric lensectomy with primary IOL implantation and association with age at surgery and IOL location.Design, Setting, and ParticipantsThis prospective cohort study used Pediatric Eye Disease Investigator Group cataract registry data from 61 institution- and community-based practices over 3 years (June 2012 to July 2015). Participants were children younger than 13 years without baseline glaucoma who had primary IOL implantation (345 bilateral and 264 unilateral) for nontraumatic cataract. Data analysis was performed between September 2021 and January 2023.ExposuresLensectomy with primary IOL implantation.Main Outcome and MeasuresFive-year cumulative incidence of complications by age at surgery (&lt;2 years, 2 to &lt;4 years, 4 to &lt;7 years, and 7 to &lt;13 years) and by IOL location (sulcus vs capsular bag) were estimated using Cox proportional hazards models.ResultsThe cohort included 609 eyes from 491 children (mean [SD] age, 5.6 [3.3] years; 261 [53%] male and 230 [47%] female). Following cataract extraction with primary IOL implantation, a frequent complication was surgery for visual axis opacification (VAO) (cumulative incidence, 32%; 95% CI, 27%-36%). Cumulative incidence was lower with anterior vitrectomy at the time of IOL placement (12%; 95% CI, 8%-16%) vs without (58%; 95% CI, 50%-65%), and the risk of undergoing surgery for VAO was associated with not performing anterior vitrectomy (hazard ratio [HR], 6.19; 95% CI, 3.70-10.34; P &lt; .001). After adjusting for anterior vitrectomy at lens surgery, there were no differences in incidence of surgery for VAO by age at surgery (&lt;2 years, HR, 1.35 [95% CI, 0.63-2.87], 2 to &lt;4 years, HR, 0.86 [95% CI, 0.44-1.68], 4 to &lt;7 years, HR, 1.06 [95% CI, 0.72-1.56]; P = .74) or by capsular bag vs sulcus IOL fixation (HR, 1.22; 95% CI, 0.36-4.17; P = .75). Cumulative incidence of glaucoma plus glaucoma suspect by 5 years was 7% (95% CI, 4%-9%), which did not differ by age after controlling for IOL location and laterality.Conclusions and RelevanceIn this cohort study, a frequent complication following pediatric lensectomy with primary IOL was surgery for VAO, which was associated with primary anterior vitrectomy not being performed but was not associated with age at surgery or IOL location. The risk of glaucoma development across all ages at surgery suggests a need for long-term monitoring.

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Incidence, Risk Factors, and Outcomes of Retinal Detachment after Pediatric Cataract Surgery

Cited by 41 publications

References 32 publications

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

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

Rhegmatogenous Retinal Detachment after Pediatric Cataract Surgery

Complications Occurring Through 5 Years Following Primary Intraocular Lens Implantation for Pediatric Cataract

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