Some Lessons Regarding Intraocular Lens Implantation Following Pediatric Cataract Surgery

Liu, Zhenzhen

doi:10.1001/jamaophthalmol.2023.2672

Cited by 2 publications

(2 citation statements)

References 5 publications

(6 reference statements)

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“…After cataract extraction with primary IOL implantation in children, visual axis opacification is the most common complication requiring reoperation [ 16 , 17 , 19 ]. In a 5-year follow-up study after cataract surgery among children younger than 13 years, the cumulative incidence of significant visual axis opacification was reported as 33% for bilateral pseudophakia and 34% for unilateral pseudophakia [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prior long-term studies indicated a frequent occurrence of glaucoma-related complications following infantile cataract removal [3,7]. On the other hand, more recent reports utilizing modern surgical techniques revealed a reduced incidence of glaucoma in pseudophakic eyes, indicating that primary IOL implantation combined with anterior vitrectomy does not elevate the risk of secondary glaucoma [16][17][18][19]. In addition, other large-scale analyses underscored that primary IOL implantation serves as a protective factor against glaucoma development after congenital cataract surgery [20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

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10-Year Outcomes of Pediatric Cataract Surgery with Foldable Intraocular Lens Implantation and Posterior Continuous Curvilinear Capsulorhexis

Oshika,

Kiuchi

2023

Ophthalmol Ther

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Introduction We investigated the long-term outcomes of pediatric cataract surgeries performed with modern surgical techniques involving in-the-bag implantation of a foldable intraocular lens (IOL). Methods Data were retrospectively collected from 42 eyes in 30 patients who underwent surgery at 6 years and younger (average 2.5 ± 2.3 years) and were followed up for an average of 12.2 ± 2.4 years (10–17 years). Surgical procedures included anterior continuous curvilinear capsulorhexis (CCC), lens removal, posterior CCC, anterior vitrectomy, and in-the-bag IOL implantation. There were 18 unilateral (2.7 ± 2.3 years) and 12 bilateral cases (2.3 ± 2.3 years), with no significant age difference between groups ( p = 0.462). Results The mean best-corrected visual acuity (BCVA) at the final visit was 0.453 ± 0.488 (logMAR), correlating significantly with the age at surgery ( r = −0.307, p = 0.048). The unilateral group had a worse BCVA (0.658 ± 0.615) than the bilateral group (0.298 ± 0.294) ( p < 0.001). On average, eyes showed a myopic shift of −6.0 ± 6.3D, which significantly correlated with surgical age ( r = 0.402, p = 0.008). While the myopic shift was −8.2 ± 6.1 D in the unilateral group and −4.9 ± 6.4 D in the bilateral group, the net shift for unilateral cases (comparing pseudophakic and fellow eyes) was −4.8 D. Three eyes (7.1%) exhibited suspected glaucoma (increased intraocular pressure), but no glaucoma or other severe complications were noted. IOL exchange surgery was necessary in two eyes (4.8%) due to pronounced myopic drift and significant IOL decentration. Three eyes (7.1%) required surgery for significant visual axis opacification. Conclusions Contemporary surgical strategies appear to yield promising long-term outcomes in patients with infantile cataracts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

10-Year Outcomes of Pediatric Cataract Surgery with Foldable Intraocular Lens Implantation and Posterior Continuous Curvilinear Capsulorhexis

Oshika,

Kiuchi

2023

Ophthalmol Ther

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Long-term surgical outcomes of pediatric cataract—multivariate analysis of prognostic factors

Oshika,

Endo,

Kurosaka

et al. 2023

Sci Rep

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We assessed the 10-year postoperative outcomes of pediatric cataract patients who underwent surgery at the age of 6 years or younger. A retrospective review of medical charts was conducted for 457 eyes of 277 patients, with the age at surgery averaging 1.3 ± 1.5 years (mean ± SD) and the follow-up duration averaging 12.8 ± 2.4 years (ranging from 10 to 17 years). The cohort included 250 eyes of 125 cases with bilateral aphakia (age at surgery 0.5 ± 0.8 years), 110 eyes of 55 cases with bilateral pseudophakia (1.9 ± 1.6 years), 42 cases with unilateral aphakia (1.1 ± 1.3 years), and 55 cases with unilateral pseudophakia (2.6 ± 1.7). A forward stepwise multiple regression analysis revealed that the best-corrected visual acuity at the final visit was significantly associated with laterality of cataract (with bilateral cases showing better results compared to unilateral cases), presence of systemic comorbidities, presence of ocular comorbidities, development of glaucoma, and phakic status (with better results in the pseudophakia group than the aphakia group). The age at surgery did not significantly affect visual acuity outcomes. A multiple logistic regression analysis demonstrated that the incidence of secondary glaucoma was significantly linked to younger age at surgery, phakic status (higher in aphakic than pseudophakic eyes), and presence of systemic comorbidities. In conclusion, after pediatric cataract surgery, final visual acuity was better in patients with bilateral cataracts, those treated with an intraocular lens, and cases without systemic or ocular comorbidities and secondary glaucoma. The development of secondary glaucoma was linked to younger age at surgery, aphakic status, and presence of systemic comorbidities.

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Some Lessons Regarding Intraocular Lens Implantation Following Pediatric Cataract Surgery

Cited by 2 publications

References 5 publications

10-Year Outcomes of Pediatric Cataract Surgery with Foldable Intraocular Lens Implantation and Posterior Continuous Curvilinear Capsulorhexis

10-Year Outcomes of Pediatric Cataract Surgery with Foldable Intraocular Lens Implantation and Posterior Continuous Curvilinear Capsulorhexis

Long-term surgical outcomes of pediatric cataract—multivariate analysis of prognostic factors

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