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Bilateral cataract surgery in children: immediate sequential versus delayed sequential surgery.

Helen Wondem1, Sheldon Stohl2, Zoma Tede3

  • 1Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|September 14, 2024
PubMed
Summary
This summary is machine-generated.

Immediate sequential bilateral cataract surgery (ISBCS) in children is as safe as delayed surgery (DSBCS), with fewer anesthesia exposures and shorter hospital stays. This approach offers a safe alternative for pediatric cataract treatment.

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Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Anesthesiology

Background:

  • Bilateral cataract surgery in infants presents surgical timing choices.
  • Immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS) are two such approaches.
  • Comparing complication rates and resource utilization is crucial for optimizing pediatric care.

Purpose of the Study:

  • To compare ocular and anesthesia-related complications between ISBCS and DSBCS in pediatric patients.
  • To evaluate differences in anesthesia time, surgical interventions, and hospital admissions.

Main Methods:

  • Retrospective review of medical records for children aged 0-24 months undergoing bilateral cataract surgery between 2012 and 2021.
  • Inclusion criteria: aphakia and at least 1 year of follow-up.
  • Comparison of complication rates, anesthesia duration, procedure time, and hospital resource use between ISBCS and DSBCS groups.

Main Results:

  • 56 children included: 23 ISBCS, 33 DSBCS. Mean age at surgery was similar (2.6 vs. 2.8 months).
  • ISBCS group had shorter mean anesthesia time (P < 0.001) and fewer hospital nights (P < 0.001).
  • Ocular and anesthesia complication rates were similar; no endophthalmitis cases. Total procedure time and follow-up visits were comparable.

Conclusions:

  • ISBCS in children is not associated with increased ocular or anesthesia-related complications compared to DSBCS.
  • ISBCS offers benefits by avoiding repeat anesthesia and reducing total anesthesia exposure time.
  • This suggests ISBCS is a safe and potentially more efficient option for pediatric bilateral cataract surgery.