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Published on: July 7, 2023
[Results of pars plana lensectomy for childhood cataract]
B Gessner1, S Wiese, W A Lagrèze
1Augenklinik, Universität Freiburg.
Insights
Early lensectomy surgery for pediatric cataracts yields better visual outcomes in bilateral cases. Achieving good vision requires timely intervention, proper orthoptic therapy, and consistent contact lens wear.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Context:
- Congenital cataracts require prompt treatment to prevent visual impairment.
- Pars plana lensectomy with contact lens fitting is the standard surgical approach for early-onset cataracts.
Purpose:
- To evaluate the outcomes and complication rates of pars plana lensectomy in children with congenital cataracts.
- To determine the correlation between age at surgery and visual acuity.
Summary:
- Pars plana lensectomy was performed on 41 eyes (29 bilateral, 12 unilateral) in children under 3 years old.
- Bilateral cases showed a mean visual acuity of 0.32, with a significant correlation between earlier surgery and better outcomes.
- Unilateral cases had a mean visual acuity of 0.14, with no significant age correlation; 40% of bilateral and 17% of unilateral cases achieved binocular vision.
Impact:
- Early surgical intervention, orthoptic therapy, and contact lens compliance are crucial for optimal visual function in pediatric cataract patients.
- Bilateral congenital cataracts generally have better visual outcomes post-lensectomy compared to unilateral cases.
Background:
Pars plana lensectomy with subsequent fitting of contact lenses is the standard procedure for cataracts occurring within the first 2 years of life. We wanted to assess the outcome and complication rate of this procedure.
Methods:
Pars plana lensectomy was performed on 29 eyes of 15 children with bilateral as well as 12 eyes with unilateral cataracts. All children were reexamined at an age of at least 3 years.
Results:
In bilateral cases the mean age at the time of surgery was 4.0 months and mean resulting visual acuity 0.32. After exclusion of three eyes with complications or bad postoperative compliance, we found a statistically significant correlation between age at surgery and visual acuity (r(2)=0.432, p<0.05). Some form of binocular vision was achieved by 40% of the children; 17% developed ocular hypertension and 7% a secondary cataract. In the unilateral cases the mean age at surgery was 3.9 months and the mean resulting visual acuity 0.14. There was no significant correlation between age and visual acuity; 17% gained binocular function and 5% had ocular hypertension.
Conclusion:
Visual function after lensectomy is better in eyes with bilateral cataracts compared to unilateral cataracts. Early surgery as well as adequate orthoptic therapy and compliance with wearing the contact lens are necessary for good outcome.
