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Visual outcome of cataract surgery in children with congenital rubella syndrome
Perumalsamy Vijayalakshmi1, Kuldeep Kumar Srivastava, Balajee Poornima
1Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Care System, Madurai, India.
Purpose:
To evaluate visual outcome after cataract surgery in children with congenital rubella syndrome (CRS).
Methods:
A retrospective analysis was conducted on 40 eyes of 22 children with CRS who underwent cataract surgery. Thirty-six eyes underwent lensectomy with anterior vitrectomy, and 4 eyes underwent extracapsular cataract extraction with primary posterior capsulectomy. The median age at surgery was 6 months, and median duration of postoperative follow up was 68.5 months. Each follow-up visit consisted of visual acuity estimation, refraction, anterior and posterior segment examination, and intraocular pressure measurements.
Results:
Visual acuity at final follow up was 6/24 or better in 6 (15.0%) eyes, and 22 (55.0%) eyes had visual acuity less than 3/60. Postoperative complications included transient corneal edema in 18 (45.0%) eyes, glaucoma in 5 (12.5%) eyes, after cataract in 1 (2.5%) eye, and hyphema in 1 (2.5%) eye. Ocular disorders affecting visual outcome included stimulus deprivation amblyopia, glaucoma, optic atrophy, corneal opacity, and after cataract. Associated systemic disorders included neurological problems in 15 (68.2%), hearing loss in 12 (54.6%), cardiovascular problems in 9 (40.9%), and speech abnormalities in 7 (31.8%) children.
Conclusions:
The less-than-optimal postoperative visual outcome suggests the need to look at primary prevention of rubella, especially in developing countries.
