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Cataract surgery in children with and without retinopathy of prematurity
Young Suk Yu1, Seong-Joon Kim, Bong Leen Chang
1Department of Ophthalmology, College of Medicine, and Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Seoul, South Korea. ysyu@snu.ac.kr
Insights
Cataract surgery, including posterior chamber intraocular lens (PC IOL) implantation, shows promising outcomes in premature infants, even with retinopathy of prematurity (ROP). Careful monitoring is crucial for ROP cases.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinopathy of Prematurity Research
Background:
- Cataract surgery in premature infants presents unique challenges.
- The impact of retinopathy of prematurity (ROP) on surgical outcomes is not well-defined.
Purpose of the Study:
- To evaluate cataract surgery outcomes in premature infants.
- To compare outcomes between infants with and without retinopathy of prematurity (ROP).
Main Methods:
- Retrospective chart review of 26 eyes from 14 premature infants undergoing cataract surgery.
- Surgical techniques included lensectomy, vitrectomy, and intraocular lens (IOL) implantation.
- Postoperative visual acuity and optical correction methods were documented.
Main Results:
- Good visual acuity (better than 20/80) was achieved in most eyes post-surgery.
- Eight eyes had varying stages of retinopathy of prematurity (ROP).
- One patient with severe ROP underwent combined cataract and scleral buckle surgery.
Conclusions:
- Posterior chamber intraocular lens (PC IOL) implantation offers encouraging results for premature infants with cataracts, irrespective of ROP.
- Close monitoring and timely surgical intervention are vital for premature infants with co-existing ROP and cataracts.
Purpose:
To report the outcomes of cataract surgery in children born prematurely who had or did not have retinopathy of prematurity (ROP).
Setting:
Seoul National University Hospital, Department of Ophthalmology, Seoul, Korea.
Methods:
Retrospective studies were conducted by reviewing the charts of 26 eyes of 14 premature infants with or without ROP that had cataract surgery. The patients' preoperative characteristics and postoperative visual outcomes were documented. Cataract surgery consisted of lensectomy, posterior capsulectomy, and anterior vitrectomy in patients younger than 2 years and primary posterior chamber intraocular lens (PC IOL) implantation or secondary PC IOL implantation in those 2 years or older. Postoperative optical correction in those younger than 2 years was by glasses or contact lenses.
Results:
Eight eyes of 5 patients had acute ROP; 4 eyes had stage 3, 2 had stage 2, and 2 had stage 1. Three eyes had transconjunctival cryotherapy for treatment of threshold ROP. First-eye cataract surgery were performed in children from 0.2 to 5.5 years old (mean 1.5 years) and second-eye surgery, in children from 1.8 to 12.1 years old (mean 4.3 years). Twenty eyes had implantation of a PC IOL. In 1 patient with stage 3+ ROP, Rush (plus) type, both eyes had combined cataract and scleral buckle encircling surgery. The mean follow-up after the last surgery was 1.4 years (0.5 to 3.1 years). At the last examination, the best corrected visual acuity was good fixation or better than 20/80 except in 2 eyes, 1 with esotropia and the other with a dense pupillary membrane.
Conclusions:
This is the first report of an encouraging surgical outcome for PC IOL implantation in premature infants with cataract regardless of the presence of ROP. However, if retinopathy is present and has progressed in the cataractous eye of a premature child, careful examination and timely surgical decisions are important.
