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Medical Management of Children With Congenital/Infantile Cataract Associated With Microphthalmia, Microcornea, or

Moritz Claudius Daniel, Gillian G W Adams, Annegret Dahlmann-Noor

    Journal of Pediatric Ophthalmology and Strabismus
    |October 30, 2018
    PubMed

    Insights

    Early cataract surgery in children with microphthalmia, microcornea, or persistent fetal vasculature (MMP) increases glaucoma risk without improving visual outcomes. Isolated cataracts show better results with later intervention.

    Area of Science:

    • Ophthalmology
    • Pediatric Surgery
    • Genetics

    Background:

    • Congenital cataracts require timely intervention.
    • Microphthalmia, microcornea, or persistent fetal vasculature (MMP) are complex ocular conditions.
    • The impact of early surgery on visual outcomes and glaucoma risk in MMP-associated cataracts is not fully understood.

    Purpose of the Study:

    • To compare surgical outcomes in children with cataracts associated with MMP versus isolated cataracts.
    • To evaluate the effect of early versus later cataract surgery on visual acuity and glaucoma development.

    Main Methods:

    • Retrospective study of 111 children (<16 years) undergoing cataract surgery.
    • Groups: cataract with MMP (n=25) and isolated cataract.
    • Outcomes: best corrected visual acuity (BCVA) and glaucoma prevalence.
    • Age at surgery dichotomized: early intervention (≤48 days) vs. later intervention.

    Main Results:

    • Children with MMP-associated cataracts had a median surgery age of 3.9 months; isolated cataracts had a median of 23.3 months.
    • In MMP cataracts, visual acuity was similar for early (80% >0.3 logMAR) and later (78% >0.3 logMAR) surgery.
    • Glaucoma prevalence was high (28%) in MMP-associated cataracts, with lower rates in later intervention.

    Conclusions:

    • Early cataract surgery in MMP-associated cases carries a high risk of post-lensectomy glaucoma.
    • Early intervention does not improve visual outcomes in children with MMP-associated cataracts.
    • Later surgical intervention may be beneficial for isolated congenital cataracts.
    Abstract

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