Retinal detachment following surgery for congenital cataract: presentation and outcomes

Abstract

Aims To review the current management and outcomes of retinal detachment following cataract surgery in childhood. Methods A retrospective review of 59 eyes of 52 patients. Results In 37% of patients, the fellow eye was blind (o3/60). The macula was detached at presentation in 81% of eyes. The detachment was obscured by residual lens matter, or a miotic pupil in 67% of eyes that had cataract surgery before 1970, but in only 30% of eyes operated after 1970. The retina was reattached with one operation in 59% of eyes, and final reattachment was achieved in 81%. No retina was reattached by scleral buckling alone. Visual outcomes were slightly better in eyes that had retinal detachment repair after 1 January 1998. Nine patients were blind in both eyes at the latest follow-up. Conclusions Retinal detachment following childhood cataract surgery remains a serious condition. There has been some improvement in the prognosis due to a combination of advances in childhood cataract surgery as well as to improvements in the management of retinal detachment. Early recognition and prompt surgery, using an internal approach, may prevent blindness in most cases.

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

“…We had 3 (25%) eyes with a visual acuity of less than 3/60; this was in part due to chronic detachment with high grades of RD and amblyopia in 2 eyes and 1 eye, respectively. We had 9 (75.0%) eyes with a visual acuity better than 6/60 at final visit, which is relatively higher than that reported previously by Yorston et al 16 and Haargaard et al 11 The smaller number of patients in the RD group and inherent limitations of a retrospective study should be noted as limitations of our study. In future, similar studies from different centers with longer follow-up are required to validate our observations and reveal the true ethnic differences in risks of RD after pediatric congenital cataract surgery using modern surgical techniques.…”

Clinical and experimental advances in congenital and paediatric cataracts

“…The use of post-operative topical antibiotics, once daily mydriatics and 1-2 hourly topical steroids (decreasing over two to three months) are essential to minimize the risk of infection and inflammation. There is a longer term risk of retinal detachment in eyes that have had surgery for congenital cataract, often occurring more than 30 years after the original surgery [20].…”

Autophagy in Ocular Pathophysiology

“…Several congenital deformities of the eye occur such as coloboma, congenital glaucoma, congenital cataracts, congenital detached retina, partially persistent iridopupillary membrane, persistent hyaloid artery, microphthalmia and Peter's anomaly, Leber's Congenital Ameurosis [151][152][153][154][155][156]. While the cause of most of these diseases is rooted deep in mutation of genes such as PAX2, PAX6, CYP1B1, GLC3A, GLC3B, GLC3C, FOXC1, CEP290, CRB1, GUCY2D, RPE65, several reports suggest autophagy may be compromised in some of these diseases [157].…”