Visual outcomes and complications in infantile cataract surgery: a real - world scenario

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Public Health

Background:

• Infantile cataracts significantly impact visual development and quality of life.
• Real-world data on surgical outcomes and complications in infants are crucial for clinical decision-making.
• Understanding the long-term visual results and refractive changes is essential for managing pediatric visual impairment.

Purpose of the Study:

• To assess the visual outcomes and complications of infantile cataract surgery.
• To evaluate these outcomes over a 1-year follow-up period in a real-world setting.
• To compare visual acuity and refractive shifts between pseudophakic and aphakic eyes.

Main Methods:

• A prospective observational study was conducted on infants undergoing cataract surgery.
• Data from 173 eyes of 97 infants (median age 18.7 weeks) were analyzed.
• Visual acuity, refractive error, and complications were recorded at 1-year follow-up.

Main Results:

• The most common etiologies were infections (toxoplasmosis, rubella, CMV, herpes) and familial/syndromic cases.
• Fifty-four eyes (29.5%) received primary intraocular lens (IOL) implantation.
• At 1-year, mean visual acuity was 1.00 logMAR (unilateral) and 1.21 logMAR (bilateral). Pseudophakic eyes showed better acuity than aphakic eyes, though not statistically significant after correction. Significant myopic shifts were observed in both groups (-2.9 D in aphakes, -4.53 D in pseudophakes). Visual axis opacification and glaucoma were the most frequent complications.

Conclusions:

• Primary IOL implantation is a viable surgical option for infantile cataracts.
• This approach is particularly beneficial when comprehensive aftercare and refractive correction for aphakia are challenging.
• Careful patient selection and management are necessary to optimize visual outcomes and minimize complications.