Cataract surgery outcomes in pediatric patients with systemic comorbidities

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Genetics and Genetic Diseases

Background:

• Cataract surgery in pediatric patients with systemic comorbidities presents unique challenges.
• Delayed diagnosis and treatment can significantly impact visual outcomes in children.
• Understanding the spectrum of comorbidities is crucial for comprehensive care.

Purpose of the Study:

• To evaluate the outcomes of cataract surgery in pediatric patients with systemic comorbidities.
• To analyze the impact of comorbidities on visual acuity and psychomotor development post-surgery.
• To identify factors contributing to delayed surgical referral in this population.

Main Methods:

• Retrospective review of medical records for 54 eyes (30 pediatric patients) who underwent cataract surgery.
• Data collected included systemic comorbidities, TORCH profile, visual acuity (BSCVA, CDVA), strabismus, nystagmus, and cataract morphology.
• Analysis of referral delays and postoperative outcomes at a tertiary-care center.

Main Results:

• The mean age of patients was 55 months; significant delays in presentation (mean 2.23 years) were noted due to referral issues.
• Common comorbidities included periventricular leukomalacia, Down's syndrome, and seizure disorders.
• Mean BSCVA improved from 1.4 logMAR preoperatively to 1.0 logMAR at 2-year follow-up; 70% of parents reported improved psychomotor skills.

Conclusions:

• Cataract surgery is beneficial for pediatric patients with systemic comorbidities, leading to improved psychomotor skills despite suboptimal visual acuity.
• Early surgical intervention and referral to specialized centers are essential to minimize delays.
• Infrastructure availability should guide surgical decisions in intellectually impaired pediatric patients with cataracts.