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Long-term outcome and determinants of primary pediatric cataract surgery
Aljawhara Aldamri1, Saleh A AlKhaldi2, Dhabiah S AlQahtani1
1Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Insights
Pediatric cataract surgery outcomes show a significant myopic shift, especially with intraocular lens (IOL) implantation. Glaucoma is a common complication, and early intervention may reduce amblyopia.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Pediatric cataracts require timely surgical intervention.
- Long-term outcomes and complications of primary pediatric cataract surgery are crucial for patient management.
Purpose of the Study:
- To evaluate long-term outcomes of primary pediatric cataract surgery.
- To identify factors influencing success and recommend improvements in pediatric cataract care.
Main Methods:
- Retrospective cohort study of pediatric patients (≤4 years) undergoing primary cataract surgery.
- Minimum 3-year follow-up with pre- and postoperative evaluations.
- Inclusion of 202 eyes from 119 patients.
Main Results:
- Visual acuity outcomes varied, with 20% achieving 20/30 or better.
- Significant postoperative myopic shift (mean spherical equivalent 1.50D) observed, higher with primary intraocular lens (IOL) implantation.
- Amblyopia affected 120 eyes; glaucoma occurred in 19% of patients.
Conclusions:
- Postoperative myopic shift is significant, particularly with primary IOL implantation.
- Glaucoma is the most frequent postoperative complication.
- Strabismus, nystagmus, and early intervention impact visual outcomes and amblyopia incidence.
Purpose:
This study aimed to evaluate the long-term outcomes of primary pediatric cataract surgery and to identify determinants of success and recommendations to improve the care of patients with pediatric cataracts.
Methods:
A cohort, retrospective study of cases who were operated as primary pediatric cataract surgery at King Khaled Eye Specialist Hospital. Patients who are 4 years old or younger and underwent primary cataract surgery with at least 3-year follow-up were enrolled in this study. Preoperative and postoperative evaluations were performed to determine the surgery outcomes.
Results:
Two hundred and two eyes of 119 patients were enrolled in the study. Seventy percentage of the patients were diagnosed with bilateral cataracts and 30% with unilateral cataracts. Postoperative evaluation showed that 20% of the patients had best corrected visual acuity of 20/30 or better, 25% had 20/40-20/50, 20% had 20/60-20/80, and 29% had 20/100 or less, 6% as fixate and follow. In addition, the mean spherical equivalent was 1.50D. Amblyopia was present in 120 eyes. Fourteen percentage showed a significant myopic shift of more than -4.00D and it was more in eyes with primary intraocular lens (IOL) implantation. Glaucoma was reported in 19% of the patients.
Conclusion:
There was a significant postoperative myopic shift and it was more in eyes with primary IOL implantation. Glaucoma was the most common reported postoperative complication. The presence of strabismus and nystagmus may affect the visual outcomes. Early intervention might reduce the incidence of amblyopia.
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