[Congenital cataract removed early: long-term visual acuity outcome and refractive changes]

Removing pediatric crystalline lens abnormalities has improved recently. Congenital cataract is the main cause.

This retrospective study analyzed 121 eyes in children that were operated early at the Bordeaux Hospital (France) from 2000 to 2005, with no exclusion criterion. The Anova test and the Bartlett Chi2 test were used for the statistical analysis.

This cohort mainly recruited congenital cataract with half of the population operated on at less than 1 year of age, including 41 before the age of 6 months. The mean age at surgery was 1.93 years (range, 9 days to 8.86 years). Seventy-nine eyes underwent primary intraocular lens implantation (78.8% for unilateral cataracts and 55.1% for bilateral cataract). The mean postoperative refraction was +1.94 D with a mean myopic shift of -1.22 D over 2.89 years of follow-up. Of the operated eyes, 64.7% improved 0.5 D or better, with a mean gain of 0.38. The final visual acuity (AVF) was 0.51. Before the age of 1 year, the mean AVF was 4.1/10 (range, 1/50 to 12/10). The mean AVF of the implanted eyes (5.4/10+/-4.2/10) was higher than those corrected by contact lenses (2/10+/-1.6/10) (p=0.024).

Primary intraocular lens implantation provides significantly better AVF than aphakic contact lens-corrected eyes and provides better stabilization over time whatever the age.