Visual Function in Children With Posterior Lens Opacities Before and After Surgery

Chen, Wan; Chen, Hui; Lin, Zhuangling; Wang, Jinghui; Chen, Jingjing; Wang, Qiwei; Zhao, Zhongjie; Lin, Zhuoling; Lin, Xiaoshan; Li, Jing; Li, Xiaoyan; Chen, Weirong

doi:10.1016/j.ajo.2022.04.018

Cited by 5 publications

(7 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, we found cataract size had a positive correlation with the logMAR value of the final BCVA, which means a better visual outcome was achieved in eyes with a smaller size of cataract, which was also consistent with previous reports [ 23 , 37 ]. Although it was not significantly associated with low vision, this parameter could be taken into consideration when making a surgical decision.…”

Section: Discussionsupporting

confidence: 93%

“…Denser cataracts were defined as grade 8 or above, and less dense cataracts were defined as grade under 8 [ 22 ]. Moreover, the location and size of cataracts were also measured preoperatively based on the work of Chen et al [ 23 ]. Briefly, cataracts not fully covering the 3 mm of the center of the lens were categorized as paracentral, while cataracts more than 3 mm from the center of the lens were categorized as central ( Figure 2 a).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Lin

Liu

et al. 2023

JPM

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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

Lin

Liu

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

“…19 In our study, 3 of 5 patients who did not experience any improvement in VA postoperatively had corneal astigmatism exceeding 2.0 D. Similarly, the better VA prognosis group (VA better than 0.3 logMAR) exhibited smaller corneal astigmatism (Table 4). Moreover, correlation analysis revealed a relationship between the degree of postoperative VA improvement and the size of preoperative corneal astigmatism ( r = 0.384, P = .036), which is consistent with previous research conducted by Chen et al 18…”

Section: Discussionsupporting

confidence: 91%

“…It is believed that this irregular astigmatism of the cornea may compensate for the abnormal refractive state of the lens. 18 However, on the other hand, astigmatism may also negatively affect the postoperative recovery of VA. Previous studies have suggested that astigmatism (regular astigmatism >1.5 D or irregular astigmatism >1.0 D) may lead to amblyopia.…”

Section: Discussionmentioning

confidence: 99%

Multifocal intraocular lens implantation in children with unilateral congenital cataracts

Jiang,

Zhang,

Ding

et al. 2023

J Cataract Refract Surg

View full text Add to dashboard Cite

Purpose: To evaluate the vision recovery, reconstruction of binocular visual function, and influencing factors after multifocal intraocular lens implantation in children with unilateral congenital cataracts. Setting: University hospital. Design: Prospective clinical study. Methods: In the prospective clinical study, fifty-five children aged 3 to 14 with unilateral congenital cataracts received multifocal intraocular lenses (Tecnis ZMB00; Abbott Medical Optics) posterior optic capture from 2019 to 2022. Best corrected distance visual acuity(BCDVA;5m), distance-corrected intermediate visual acuity (DCIVA;66cm), distance-corrected near visual acuity (DCNVA;33cm), stereoscopic vision, visual quality (objective scatter index (OSI) and modulation transfer function (MTF)), axial length (AL), keratometry (K), and contrast sensitivity (CS), as well as postoperative occlusion compliance were evaluated before and after surgery. Results: At the final follow-up, 90.91%(50/55) patients showed significant improvement in visual acuity(VA) after surgery. BCDVA, DCIVA and DCNVA were 0.23±0.17, 0.39±0.15, and 0.44±0.15 LogMAR, respectively.69.09%(38/55) patients achieved good VA (better than 0.3 LogMAR).52.76% (25/48) patients had a positive Titmus test. OSI and MTF were 1.24±0.91 and 42.45±12.30, respectively. 73.68% (28/38) of the patients (better than 0.3 LogMAR) underwent strict occlusion therapy. Postoperative VA is correlated with preoperative BCDVA (r=-0.829, P<0.001), corneal astigmatism (r=0.384, P=0.036), △AL (difference between the cataract eyes and contralateral eyes, r=-0.490, P=0.006), and occlusion compliance (r=-0.806, P<0.001). Conclusion: Multifocal intraocular lens implantation could obtain relatively satisfactory VA (BCDVA, DCIVA and DCNVA) and the binocular visual function of children with unilateral congenital cataracts. Postoperative VA is related to preoperative VA, corneal astigmatism, △AL, and occlusion compliance.

show abstract

“…Localized protrusion of the posterior lens capsule could cause refraction variations and increase the difficulty of the surgery in children. 15 Sometimes, a posterior capsule rupture (PCR) occurs during surgery, and timely management by experienced doctors is needed. The management of posterior lentiglobus is similar to that of PCP (Figure 3 ).…”

Section: Methodsmentioning

confidence: 99%

Influence of posterior capsule abnormalities in pediatric cataract surgery

Ding,

Zhang,

Huang

2024

J Cataract Refract Surg

View full text Add to dashboard Cite

Purpose: To report how to manage posterior capsule abnormalities (PCAs) in pediatric cataracts and evaluate the influence of PCAs during intraocular lens (IOL) optic implantation in Berger space surgeries. Setting: Qingdao Eye Hospital of Shandong First Medical University in Qingdao, China Design: Retrospective case-series study. Methods: Pediatric patients with PCAs who underwent cataract surgery were evaluated. A video-based analysis of the surgical interventions included the type of crystalline lens opacification, type and management of PCAs, complications during primary posterior continuous curvilinear capsulorhexis (PCCC), need for anterior vitrectomy (AV) and feasibility of IOL optic capture. Results: There were 227 pediatric cataract surgeries during the study period, and 76 eyes of 66 children with PCAs were evaluated (33.4%,76/227). The unilateral cataract with PCAs were 50 eyes (22.0%, 50/227)and bilateral were 26 eyes(11.4%, 26/227). The PCAs were posterior capsule plaque (19.8%, 45/227), posterior capsule defect (6.2%, 14/227), posterior lenticonus (3.1%, 7/227) and persistent fetal vasculature (4.4%, 10/227). In the PCA cases, primary PCCC was successful in 44.7% of the cases (34/76). An unplanned anterior vitrectomy during the surgeries was performed in 47.4% (36/76) of the 76 eyes. IOL optic implantation in Berger space was achieved in 63.2% of the eyes (48/76). Conclusions: PCAs are often encountered during pediatric cataract surgeries, especially in unilateral cases. The presence of PCAs may complicate a primary PCCC procedure, resulting in an unplanned AV in some cases. IOL optic implantation in Berger space can also be performed fortunately with well-designed and skilled operation.

show abstract

Visual Function in Children With Posterior Lens Opacities Before and After Surgery

Cited by 5 publications

References 27 publications

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

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

Multifocal intraocular lens implantation in children with unilateral congenital cataracts

Influence of posterior capsule abnormalities in pediatric cataract surgery

Contact Info

Product

Resources

About