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Postcataract surgery outcome in a series of infants and children with Down syndrome
C Gardiner1, B Lanigan, M O'Keefe
1The Children's University Hospital, Temple Street, Dublin 1, Ireland.
Insights
Cataract extraction in children with Down syndrome yielded encouraging visual outcomes. This safe procedure showed good visual acuity, though significant myopic shifts and posterior capsular opacification were noted.
Area of Science:
- Ophthalmology
- Genetics
- Pediatric Medicine
Background:
- Children with Down syndrome (DS) have a higher prevalence of lens opacities requiring cataract extraction.
- Understanding the outcomes of cataract surgery in this population is crucial for effective management.
Purpose of the Study:
- To evaluate the visual and refractive results of cataract extraction in children with Down syndrome.
- To identify and report complications associated with the procedure in this cohort.
Main Methods:
- Retrospective review of case notes for 18 children with Down syndrome who underwent cataract extraction between 1981 and 2006.
- Analysis of visual acuity, refractive outcomes, axial length changes, and postoperative complications.
Main Results:
- 40% of patients achieved a postoperative best-corrected visual acuity (BCVA) between 6/9 and 6/18.
- Significant myopic shifts (-7.96 D for aphakes, -8.06 D for pseudophakes) and increased axial length were observed.
- Posterior capsular opacification (PCO) occurred in 30% of eyes, and complications included aphakic glaucoma and retinal detachments.
Conclusions:
- Cataract extraction is a safe and effective procedure for children with Down syndrome.
- The surgery offers encouraging visual outcomes despite potential refractive shifts and complications.
Aims:
To report the visual and refractive outcome and complications in children with Down syndrome undergoing cataract extraction.
Methods:
The case notes of 18 infants and children with lens opacities and Down syndrome who underwent cataract extraction between January 1981 and August 2006 were reviewed.
Results:
Over the 25-year study period, 7% (33 eyes) of paediatric eyes undergoing cataract extraction had Down syndrome. The average follow-up time was 11.2 (SD 7.5) years with a range of 2.5 months to 25 years. 25 were congenital, and eight were developmental lens opacities. 40% of patients attained a postoperative BCVA between 6/9 and 6/18. There was a large myopic shift of -7.96 (4.7) D for aphakes and -8.06 (7.4) D for pseudophakes with an average increase in axial length of 3.58 (3.14) mm. There was a 30% incidence of posterior capsular opacification (PCO) overall, 38% in eyes without a primary posterior capsulotomy. Five eyes developed aphakic glaucoma, one eventually necessitating an enucleation. Two patients had retinal detachments on follow-up.
Conclusion:
Cataract extraction in our population of children with Down syndrome is a safe and effective procedure with a very encouraging visual outcome.
