Visual Axis Opacity after Intraocular Lens Implantation in Children in the First 2 Years of Life

Solebo, Ameenat Lola; Rahi, Jugnoo S

doi:10.1016/j.ophtha.2020.02.038

Cited by 11 publications

(12 citation statements)

References 29 publications

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“…The records after May 2018 are not available for this test because of the incomplete 1-year follow-up records when we submitted this work. Fourth, the complications' prevalence in our study is higher than those reported by previous studies [31][32][33] . It may be attributed to difference of measurement and definition, or "severe patient effects" (that is, infants with complications have better compliance and thus are more likely to have complete follow-up records).…”

Section: Discussioncontrasting

confidence: 83%

Artificial intelligence manages congenital cataract with individualized prediction and telehealth computing

Long

Chen

et al. 2020

npj Digit. Med.

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A challenge of chronic diseases that remains to be solved is how to liberate patients and medical resources from the burdens of long-term monitoring and periodic visits. Precise management based on artificial intelligence (AI) holds great promise; however, a clinical application that fully integrates prediction and telehealth computing has not been achieved, and further efforts are required to validate its real-world benefits. Taking congenital cataract as a representative, we used Bayesian and deep-learning algorithms to create CC-Guardian, an AI agent that incorporates individualized prediction and scheduling, and intelligent telehealth follow-up computing. Our agent exhibits high sensitivity and specificity in both internal and multi-resource validation. We integrate our agent with a web-based smartphone app and prototype a prediction-telehealth cloud platform to support our intelligent follow-up system. We then conduct a retrospective self-controlled test validating that our system not only accurately detects and addresses complications at earlier stages, but also reduces the socioeconomic burdens compared to conventional methods. This study represents a pioneering step in applying AI to achieve real medical benefits and demonstrates a novel strategy for the effective management of chronic diseases.

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Section: Discussioncontrasting

confidence: 83%

Artificial intelligence manages congenital cataract with individualized prediction and telehealth computing

Long

Chen

et al. 2020

npj Digit. Med.

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“…Regarding postoperative complications, visual axis opacification is the postoperative complication responsible for the largest number of reinterventions in pediatric cataract surgeries with primary IOL implantation, reaching 68% in unilateral (3) and 32% in bilateral cataracts (12) in children aged 1 to 7 months of age at surgery and within a 5-year follow-up. However, this complication frequently occurs in the first year of follow-up (13) . In the present study, visual axis opacification occurred in 37.04% of the <7 mo age group.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of primary intraocular lens implantation for the treatment of aphakia in pediatric cataracts in the Brazilian public health system

Rodrigues¹,

Silva²,

Queiroz³

2022

ABO

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To evaluate primary intraocular lens implantation in the treatment of children's aphakia in the Brazilian public health system and compare the outcomes among different age groups. Methods: Children aged 0-12 years old with unilateral or bilateral congenital/developmental cataracts and underwent primary intraocular lens implantation were included. Results: A total of 108 eyes from 68 children were evaluated, and the children were divided into four age groups (<7 months [mo]; 7 mo-2 years old [y/o]; 2-5 y/o, and >5 y/o) were evaluated. Nineteen eyes (17.59%) presented visual axis opacification as a postoperative complication, which was more frequently observed in the <7 mo age group (37.93%). The difference was significant between the <7 mo and >5 y/o age groups (p=0.002). Visual axis opacification was divided into two categories: pupillary membrane and lens cell proliferation. Eight eyes presented pupillary membrane, whereas 14 showed lens cell proliferation. Out of eight eyes with pupillary membrane, seven occurred in the <7 mo age group. The difference between the <7 mo age group and the 2-5 y/o or >5 y/o age group was significant (p=0.01). Lens cell proliferation was more frequent in the <7 mo and 2-5 y/o age groups, but the difference was significant only between the < 7 mo age group and >5 y/o age group (p=0.040). Glaucoma and glaucoma suspect cases were not observed during the follow-up period. Conclusions: The main complication found in the study was visual axis opacification, which had a higher incidence in children operated on or before the age of 7 months.

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“…This may be attributed to the fact that children with aniridia, congenital glaucoma, microcornea, microphthalmos, persistent primary vitreous, Marfan syndrome, history of ocular trauma, and PFV were excluded in our study, whereas these patients are always associated with a high incidence of postoperative complications. Anyway, microincision vitrectomy instruments can minimize disturbance and irritation to the iris, decreasing the intraoperative and postoperative inflammation which contributes to the formation of VAO [ 7 ], and the limbal incision could avoid trabecular meshwork injury may also contribute to a lower incidence of postoperative glaucoma. A higher incidence of VAO was observed in younger children than in elder children.…”

Section: Discussionmentioning

confidence: 99%

“…This finding was similar to the results of previous studies. The IoLunder2 cohort study pointed out that increasing age at surgery was independently protective against the development of VAO [ 7 , 29 ]. The Infant Aphakia Treatment Study Group (IATS) also indicated that IOL implantation in children younger than 2 years of age carries a greatly increased risk of requiring secondary procedures for VAO [ 8 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, surgical management is still a challenging task because of the soft eyeball wall, elastic lens capsule, various morphologies of cataracts, and elevated inflammatory reaction due to irritation of the iris [ 1 ]. Postoperative complications are also more common in young children than adults, such as visual axial opacification (VAO), secondary glaucoma, IOL dislocation, and corectopia, which are still major obstacles to visual rehabilitation [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Outcomes of Lensectomy-Vitrectomy with Primary Intraocular Lens Implantation in Children with Bilateral Congenital Cataracts

Lin

Liu

et al. 2023

JPM

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In this study, we evaluated the long-term surgical outcomes of lensectomy-vitrectomy with primary intraocular lens (IOL) implantation in children with bilateral congenital cataracts (CCs) and investigated the potential risk factors for low vision. A total of 148 eyes in 74 children who underwent lensectomy-vitrectomy with primary IOL implantation were enrolled in this study. The surgery age was 44.04 ± 14.60 months, with a follow-up period of 46.66 ± 14.34 months. The final BCVA was 0.24 ± 0.32 logMAR, and low vision was found in 22 eyes (14.9%). Postoperative complications requiring additional surgeries included VAO (4 eyes, 5.4%), IOL pupillary captures (2 eyes, 2.0%), iris incarceration (1 eye, 0.7%), and glaucoma (1 eye, 0.7%). A higher incidence of VAO and larger postoperative refractive error was observed in younger children (≤2 years old) than in elder children (>2 years old) (p = 0.003, p = 0.047, respectively). Final BCVA was affected by preexisting comorbidity (p < 0.001), cataract density (p < 0.001), cataract size (p = 0.020), occurrence of postoperative complications (p = 0.011), and ASE (p = 0.008). Multivariate analysis showed that denser cataracts (OR = 9.303, p = 0.035) and preexisting comorbidity (OR = 4.712, p = 0.004) were the significant predictors of low vision. In conclusion, lensectomy-vitrectomy with primary IOL implantation is an effective and safe treatment for CC. The long-term visual outcome is encouraging in children with bilateral CC undergoing this procedure with a low rate of postoperative complications requiring surgeries. Moreover, eyes with denser cataracts and preexisting comorbidity may have a high risk of low vision.

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Visual Axis Opacity after Intraocular Lens Implantation in Children in the First 2 Years of Life

Cited by 11 publications

References 29 publications

Artificial intelligence manages congenital cataract with individualized prediction and telehealth computing

Artificial intelligence manages congenital cataract with individualized prediction and telehealth computing

Surgical outcomes of primary intraocular lens implantation for the treatment of aphakia in pediatric cataracts in the Brazilian public health system

Surgical Outcomes of Lensectomy-Vitrectomy with Primary Intraocular Lens Implantation in Children with Bilateral Congenital Cataracts

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