Long-term visual outcome of congenital cataract at a Tertiary Referral Center from 2004 to 2014

Abstract

PurposeTo assess the long-term visual acuity (VA) outcome after congenital cataract surgery at Imam Hossein Medical Center (Tertiary Referral Center) (2004–2014).MethodsIn this descriptive study, records of 120 patients with a history of congenital cataract surgery were studied. Those with traumatic, metabolic cataract, aged <5 years at the last visit who were not able to respond VA testing accurately and follow-up < 6 months were excluded. Cases with incomplete files were recalled and reexamined. Finally, the records of 42 patients (71 eyes) were included.ResultsIn this study, 20 males and 22 females with a mean age of 11.80 ± 6 years at their last visit were studied. Bilateral and unilateral cataract was seen in 69% and 31% of cases, respectively. Posterior and anterior subcapsular opacity was the most common (53.70%) and rarest (1.90%) type of congenital cataract, respectively. The mean age at the time of operation and surgical interval was 65 ± 66.6 (range: 1–200) and 12.9 ± 23.5 (range: 0–96) months, respectively. The most common method of refractive error correction was pseudophakia plus glasses (56.3%) with the mean best corrected visual acuity (BCVA) of 0.29 ± 0.28 LogMAR., The mean BCVA was 0.7 ± 0.53 LogMAR for aphakic patients correcting by glasses. In our study, amblyopia (56%), glaucoma (23.90%), and posterior capsular opacity (16.40%) were observed during their follow-ups on an average of 76 ± 65 months (median: 60, range: 6–240). Unilateral cataract, aphakia, nystagmus, female gender, and strabismus were risk factors of VA loss.ConclusionBased on our results, 56% of cases showed amblyopia. It could be due to late operation (especially in unilateral cases), longer surgical interval between two eyes, and no compliance of amblyopia therapy. Early detection through screening may reduce the rate of amblyopia. Refractive errors, visual acuity, amblyopia, glaucoma, posterior capsular opacity, and compliance of amblyopia therapy should be checked regularly at follow-up visits.

Outcome of Pediatric Cataract Surgeries in a Tertiary Center in Switzerland

“…The majority (68.3%) presented with isolated cataracts without associated anomalies, which is in accordance with previous reports [ 3 , 17 ]. The presentation of bilateral cataract in 72.3% is in agreement with previous reports from different geographical areas [ 3 , 4 , 18 , 19 ].…”

“…We identified a statistically significant greater number of patients with nystagmus at last follow-up in the aphakic than in the IOL group. Furthermore, nystagmus was diagnosed more often in the bilateral than in the unilateral group at last follow-up, as also documented in other studies [ 18 , 43 , 44 ]. However, the small number of patients does not allow us to confirm a higher likelihood of nystagmus in children after bilateral than in unilateral cataract surgery.…”

Analysis of Factors Associated with the Ocular Features of Congenital Cataract Children in the Shanghai Pediatric Cataract Study

“…This suggests that the eyeball may develop differently between children with unilateral and bilateral cataract. This finding may help explain why the visual acuity of the affected eye in children with unilateral cataract was usually worse than that of the eyes in children with bilateral cataract in previous studies [ 15 – 17 ].…”

Relationship between preoperative axial length and myopic shift over 3 years after congenital cataract surgery with primary intraocular lens implantation at the National Institute of Ophthalmology of Peru, 2007&ndash;2011

“… 5 Several factors such as time of surgery, aphakia, pseudophakia, laterality, visual deprivation and axial length have been reported to influence axial growth and visual prognosis. 6 – 8 Several studies show much variability on how axial growth behaves in pseudophakic children after surgery. 9 – 15 …”