Long-term functional outcomes after congenital cataract extraction with intraocular lens implantation in children of the first year of life

Круглова, Т. Б.; Катаргина, Л А; Egiyan, N.S.; Trifonova, O. B.; Mamykina, Aleksandra S.

doi:10.17116/oftalma2020136062142

Cited by 4 publications

(4 citation statements)

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“…[16][17][18][19][20] In our practice, the surgery is preferably performed in young infants with a significant visual depravation, starting from 8 weeks of age, as in subjects younger than 4 weeks higher risk of postoperative complications have been reported. [21][22][23][24] The use of low-energy FEMTO LDV Z8 femtosecond laser for the purpose of laser-assisted anterior capsulotomy was investigated in 51 eyes of 33 paediatric patients aged from 2 months to 13 years. Currently, there are only few studies focusing on the use of the femtosecond lasers in children with a limited number of cases performed as off-label procedure and without reports on visual outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies report benefits for visual acuity, if the surgery with IOL implantation is performed at very early age 16–20. In our practice, the surgery is preferably performed in young infants with a significant visual depravation, starting from 8 weeks of age, as in subjects younger than 4 weeks higher risk of postoperative complications have been reported 21–24…”

Section: Discussionmentioning

confidence: 99%

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Femtosecond laser-assisted anterior capsulotomy in children undergoing cataract surgery: a large case series

2022

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ObjectiveTo evaluate safety and postoperative visual outcomes of low-energy femtosecond laser-assisted (FLA) anterior capsulotomy in paediatric cataract surgery.Methods and analysisWe report a retrospective single-centre consecutive case series of 51 eyes of 33 paediatric cataract patients with a mean age of 3.22 years (range: 2 months to 13 years) who underwent cataract surgery with FLA anterior capsulotomy, using FEMTO LDV Z8 femtosecond laser (Ziemer Ophthalmic Systems). Anterior laser capsulotomy, phacoaspiration and intraocular lens implantation were performed in all eyes. Both intraoperative and long-term postoperative complications, along with long-term monocular corrected distance visual acuity (CDVA), were assessed during average follow-up period of 32.96 months (range: 13–69 months).ResultsIn 48 out of 51 eyes, a well-sized and well-located anterior capsulotomy was achieved without intraoperative complications. Anterior capsule tears occurred in three eyes; however, they did not extend posteriorly and the intraocular lens were placed in the bags without any further complications. Posterior capsular opacification developed in 45.10% of eyes (23 out of 51) and was subsequently treated with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. Mean CDVA at final follow-up was 20/40 (range: 20/63 to 20/32) in unilateral cases younger than 12 months, 20/40 (range: 20/1000 to 20/25) in unilateral cases older than 12 months, 20/66 (range: 20/400 to 20/32) in bilateral cases younger than 12 months and 20/40 (range: 20/200 to 20/20) in bilateral cases older than 12 months.ConclusionsPaediatric cataract surgery with low-energy FLA anterior capsulotomy is a procedure with long-term safety, resulting in significant improvement in CDVA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Femtosecond laser-assisted anterior capsulotomy in children undergoing cataract surgery: a large case series

2022

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“…Gupta et al ( 11 ) observed a thinner choroidal thickness but a higher CVI in highly myopic patients than in emmetropic controls, suggesting a relatively greater reduction in stromal tissue than in blood vessels. To date, few studies ( 12 , 13 ) have investigated the morphological characteristics of the subfoveal choroid in eyes after CC surgery. In this study, we aimed to analyze the structures of the subfoveal choroid in terms of several choroidal parameters (SFCT, TCA, LA, SA and CVI) and further explore their association with best-corrected visual acuity (BCVA) in postoperative patients with unilateral CCs.…”

Section: Introductionmentioning

confidence: 99%

Morphological characteristics of the subfoveal choroid and their association with visual acuity in postoperative patients with unilateral congenital cataracts

et al. 2022

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Background: We aimed to evaluate the morphological characteristics of the subfoveal choroid and explore the possible association of these characteristics with best-corrected visual acuity (BCVA) in postoperative patients with unilateral congenital cataracts (CCs).Methods: This was a cross-sectional study. Subfoveal choroidal structures were measured by spectraldomain optical coherence tomography with enhanced depth imaging (EDI-OCT). Several choroidal parameters, including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal area (LA), stromal area (SA) and choroidal vascularity index (CVI), were compared between pseudophakic and contralateral healthy eyes. Then, the choroidal parameters were compared between pseudophakic eyes with a poor BCVA (>0.3 logMAR) and those with a good BCVA (≤0.3 logMAR). The performance of the choroidal parameters in detecting a poor BCVA in pseudophakic eyes was evaluated by using the area under the receiver operating characteristic curve (AUC). A logistic regression model was used to assess the association between choroidal parameters and BCVA in postoperative patients with unilateral CCs.Results: A total of 55 postoperative patients with unilateral CCs were included. The age was 6.67±2.64 years. Thinner SFCT and smaller TCA, LA, SA and CVI were observed in pseudophakic eyes than in contralateral healthy eyes. In addition, in pseudophakic eyes, those with a poor BCVA had a thinner SFCT and a smaller TCA, LA and SA than those with a good BCVA. TCA [AUC, 0.75; 95% confidence interval (CI), 0.62, 0.88], LA (AUC, 0.74; 0.61, 0.87) and SA (AUC, 0.74; 0.60, 0.87) showed acceptable discriminatory abilities on BCVA. Pseudophakic eyes with TCA ≤0.594 mm² [odds ratio (OR), 8.90; 95% CI:

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“…The observation of more severe reductions in post-surgical eyes compared with unoperated eyes may have been caused by selection bias, with more severe lens opacities having a higher likelihood to be operated on than partial cataracts which are expected to have a lesser impact on visual development ( 12 ). In 2020, a second team of clinicians confirmed foveal and choroidal underdevelopment after surgery for congenital cataract, associated with reduced visual acuity ( 13 ). A further study reported thinner subfoveal choroid in newborns with diverse conditions with foveal immaturity ( 14 ).…”

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confidence: 99%

Shining a light on foveal development after congenital cataract surgery

Dahlmann‐Noor¹,

Bailly²

2022

Ann Transl Med

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Long-term functional outcomes after congenital cataract extraction with intraocular lens implantation in children of the first year of life

Cited by 4 publications

References 9 publications

Femtosecond laser-assisted anterior capsulotomy in children undergoing cataract surgery: a large case series

Femtosecond laser-assisted anterior capsulotomy in children undergoing cataract surgery: a large case series

Morphological characteristics of the subfoveal choroid and their association with visual acuity in postoperative patients with unilateral congenital cataracts

Shining a light on foveal development after congenital cataract surgery

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