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The prevalence of visual axis opacification in the Swedish Pediatric Cataract Register
Gunilla Magnusson1,2, Jenny Gyllén1,2, Birgitte Haargaard3
1Region Västra Götaland, Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden.
Insights
Pediatric cataract surgery in Sweden showed a high incidence of visual axis opacification (VAO) in young children, particularly those operated on before six months. Bag-in-the-lens intraocular lens (IOL) implantation demonstrated a significantly lower VAO rate, suggesting its safety and efficacy.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Postoperative visual axis opacification (VAO) is a significant concern in pediatric cataract surgery.
- Early surgical intervention for congenital cataracts is crucial for visual development.
Purpose of the Study:
- To determine the incidence of VAO in children under five years undergoing cataract surgery in Sweden.
- To analyze the correlation between VAO and age at surgery, as well as surgical techniques.
Main Methods:
- Retrospective analysis of data from the Swedish Pediatric Cataract Register (PECARE).
- Inclusion of children operated on between January 1, 2007, and December 31, 2020.
- Follow-up data at 1, 2, and 5 years of age were analyzed.
Main Results:
- VAO was observed in 44.1% at 1 year, 12.7% at 2 years, and 12% at 5 years post-surgery.
- The majority of VAO cases occurred in children operated on before six months of age, especially before two months.
- Bag-in-the-lens intraocular lens (IOL) implantation was associated with significantly lower VAO rates compared to other IOL types and aphakia (p < 0.0002).
Conclusions:
- Primary bag-in-the-lens IOL implantation in children under two years is safe and effective.
- This surgical approach is associated with a low occurrence of VAO and can be considered routine in Sweden.
Purpose:
To report on the occurrence of postoperative visual axis opacification (VAO) in children younger than 5 years of age operated for cataract in Sweden, and to analyse correlations with age at surgery and surgical method.
Methods:
Data were derived from the Swedish Pediatric Cataract Register (PECARE). All children operated on between 1 January 2007 and 31 December 2020 were included. Follow-ups at 1, 2 and 5 years of age were analysed.
Results:
Cataract surgery were performed on 770 eyes belonging to 549 children (n = 282 boys, 51.4%); 327/770 (42.5%) of the children underwent surgery before 3 months of age and 216/770 (28%) before 6 weeks of age. Data on 881 follow-up visits were registered. At the follow up-visits at 1, 2 and 5 years of age, VAO was present in 154/349 (44.1%), 41/323 (12.7%) and 25/208 (12%). The majority of the children with VAO underwent cataract surgery before age 6 months, with a predominance before age 2 months. Primary IOL was implanted in 601/770 (78%) of eyes; 40.8% had an acrylic one-piece lens, 31.8% had a bag-in-the-lens IOL, 21.9% were aphakic and 5.2% had an acrylic three-piece lens. Implantation of a bag-in-the-lens IOL was related to a significantly lower occurrence of VAO compared to other types of IOL, including aphakia (p < 0.0002).
Conclusion:
Our results are in accordance with the literature. Primary bag-in-the-lens IOL implantation before 2 years of age seems adequate and safe, with a low occurrence of VAO, and can thus be continued as routine in Sweden.
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