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Visual outcomes of dense pediatric cataract surgery in eastern China
Fangqin Ma1, Meiyu Ren1, Lihua Wang1
1Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, P. R. China.
Insights
Early lensectomy before 3 months of age significantly improves visual outcomes in pediatric cataract surgery. Timely intervention and proper management are key for better final best corrected visual acuity (BCVA).
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Visual Science
Background:
- Dense pediatric cataracts pose a significant challenge to visual development.
- Early intervention is crucial for optimizing visual outcomes in affected children.
Purpose of the Study:
- To evaluate the visual outcomes of dense pediatric cataract surgery in eastern China.
- To identify risk factors associated with poor visual results in this population.
Main Methods:
- Retrospective analysis of medical records from Shandong Provincial Hospital (2007-2012).
- Inclusion criteria: dense unilateral/bilateral pediatric cataract, surgery, optical correction, patching, and >2 years follow-up.
- Analysis of risk factors for poor visual outcomes.
Main Results:
- 105 patients (181 eyes) with a mean follow-up of 46.77 months.
- 4.43% achieved 0.1 logMAR or better BCVA; 14.55% had BCVA worse than 1 logMAR.
- Lensectomy before 3 months correlated with significantly better BCVA (p=0.001).
- Later lensectomy, complications, strabismus, and nystagmus were risk factors for poor outcomes.
Conclusions:
- Performing lensectomy before 3 months of age is critical for maximizing final BCVA.
- IOL implantation, managing complications, and aggressive patching enhance visual results.
- Multifaceted management strategies are essential for improving pediatric cataract surgery outcomes.
Purpose:
To evaluate the visual outcomes of dense pediatric cataract surgery in eastern China.
Methods:
Medical records of children who underwent surgery for dense unilateral or bilateral pediatric cataract in Shandong Provincial Hospital between January 2007 and December 2012 were collected. Patients who cooperated with optical correction and aggressive patching of the sound eye and who had a minimum postoperative follow-up of more than 2 years were included. Risk factors for poor visual outcomes were analyzed.
Results:
Of the 105 eligible patients (181 eyes), 76 had bilateral cataract, and 29 unilateral. With a mean follow up of 46.77 mo (range 24.0~96.0 mo), the final best corrected visual acuity (BCVA) of 158 eyes were recorded, and 4.43% (7/158) achieved 0.1 logarithm of the minimum angle of resolution (logMAR) or better; 15.19% (24/158) obtained a BCVA between 0.1 logMAR and 0.3 logMAR; 18.99%, (30/158) between 0.3 logMAR and 0.5 logMAR; 46.84% (74/158), between 0.5 logMAR and 1 logMAR; 14.55%, worse than 1 logMAR. The mean BCVA of the patients who underwent lensectomy before 3 months of age was significantly better than that of patients who underwent lensectomy between 3 and 12 months (p = 0.001). In the same lensectomy age groups, the final BCVA of the children in the bilateral and unilateral groups did not differ significantly (P>0.05). Lensectomy after 3 months of age, postoperative complications, strabismus and nystagmus were shown to be risk factors for poor visual outcomes.
Conclusions:
Lensectomy before 3 months of age, IOL implantation, proper managing of postoperative complications, early optical correction and aggressive postoperative patching of the sound eye would increase the final BCVA for patients with dense pediatric cataract.
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