Ophthalmic outcomes five years after lensectomy among children with Down syndrome

We report demographics and post-lensectomy outcomes in 30 children (39 eyes) with Down syndrome and cataract. Mean age at first lensectomy was 3.0 years (range, 0.04-12.9); 16 of 30 patients (53%) had lensectomy before 12 months of age. The 5-year cumulative incidence of glaucoma-related adverse events was 38% (95% CI, 0%-69%); of retinal detachment, 3% (95% CI, 0%-9%). The median myopic shift in children with refractive data at 5 years was -10.00 D (IQR, -12.50 to -8.38 D) in 11 aphakic eyes and -1.50 D (IQR, -3.00 D to -0.25 D) in 7 pseudophakic eyes. The period prevalence (combining cases at baseline with those developing the condition during follow up) of strabismus by 5 years was 81% (95% CI, 40%-94%), and of nystagmus, 68% (95% CI, 41%-83%). In 11 children able to perform optotype testing, 2 of 12 study eyes (17% [95% CI, 3%-56%]) had visual acuity of 20/60 or better at 5 years.