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Cataract surgery in children with retinopathy of prematurity (ROP): surgical outcomes
Chinyelu Nkemdilim Ezisi1, Ramesh Kekunnaya1, Subhadra Jalali2
1Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
Insights
Cataract surgery in children with retinopathy of prematurity (ROP) can lead to complications and refractive errors. Outcomes are comparable to those without ROP, but careful management is essential.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Retinal Diseases
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Cataract development can be a complication of ROP or its treatment.
Purpose of the Study:
- To evaluate the outcomes of cataract surgery in pediatric patients with ROP.
- To analyze postoperative complications and visual acuity following cataract surgery in this cohort.
Main Methods:
- Retrospective case review of children diagnosed with ROP between 2001 and 2014.
- Inclusion criteria: children with ROP who underwent cataract surgery.
- Analysis of ROP treatment, cataract surgery details, complications, and visual outcomes.
Main Results:
- 22 children (28 eyes) with ROP underwent cataract surgery.
- Most common ROP stage was 4; 19 eyes had prior retinal surgery.
- Postoperative complications included visual axis opacification and glaucoma; 11/23 eyes achieved vision better than 20/200.
Conclusions:
- Cataracts can occur in children with ROP irrespective of treatment modality.
- Postoperative complications and refractive changes in ROP eyes are similar to those without ROP.
- Long-term refractive shifts (myopia) were noted in pseudophakic and aphakic eyes.
Purpose:
To report the outcomes of cataract surgery in children with retinopathy of prematurity (ROP).
Methods:
A retrospective case review of all children diagnosed with ROP from January 2001 to December 2014 was done and those who underwent cataract surgery were included in the study. Details of ROP and cataract treatment, postoperative complications and outcomes were analysed.
Results:
Of the 2258 children diagnosed to have ROP, 28 eyes of 22 children were included, 14 boys and 8 girls. Mean age at cataract surgery was 18.9 months (range 2 months to 12 years). Most common grade of ROP was stage 4 (13 eyes). Nineteen eyes underwent retinal surgery, scleral buckle (one eye) and laser (three eyes). Five eyes showed spontaneous regression. Mean duration for the development of cataract postretinal surgery was 7.76 months (range 2-32 months). Nine eyes did not receive a primary intraocular lens (IOL). Intraoperative posterior capsular rupture occurred in two eyes. Postoperative complications included visual axis opacification (four), secondary glaucoma (two) and IOL capture (one). Postoperative visual acuity assessment was possible in 23 eyes, 11 had better than 20/200 vision. Eleven patients had a follow-up of at least 2 years and the mean myopic shift at 2 years was -3.07 D in pseudophakes and -8.75 D in aphakes.
Conclusions:
Cataracts may develop in children with ROP regardless of the modality of intervention. Postoperative complications and refractive changes are similar to those in eyes without ROP.
