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Congenital cataract surgery in children with cataract as an isolated defect and in children with a systemic syndrome:
A Spierer1, H Desatnik, M Rosner
1Goldschleger Eye Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Insights
Children with congenital cataracts who have underlying systemic diseases experience poorer visual acuity outcomes after surgery compared to those with isolated cataracts. Early intervention is crucial for improving vision in these complex cases.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Genetics
Background:
- Congenital cataracts are a leading cause of childhood visual impairment.
- Understanding factors influencing visual outcomes post-surgery is critical for pediatric eye care.
- Systemic diseases can be associated with congenital cataracts, potentially impacting prognosis.
Purpose of the Study:
- To compare visual acuity outcomes in children undergoing congenital cataract surgery.
- To differentiate outcomes between isolated congenital cataracts and those associated with systemic diseases.
Main Methods:
- Retrospective chart review of 46 children (66 eyes) with congenital cataracts.
- Categorization into two groups: isolated cataract and cataract as part of a systemic disease.
Main Results:
- Significantly poorer postoperative visual acuity (better than 6/12) in the isolated cataract group (one-third of eyes) compared to the syndrome group (p=0.01).
- Nystagmus was more prevalent in the systemic disease group (40%) versus the isolated group (11%) (p=0.05).
- Surgery occurred earlier in the systemic disease group (87% within 2 years) than the isolated group (54%) (p=0.01).
Conclusions:
- Congenital cataracts associated with systemic diseases lead to poorer visual acuity outcomes post-surgery.
- Early surgical intervention is common in syndromic cases, but visual results remain suboptimal.
- Ocular comorbidities like nystagmus are more frequent in syndromic congenital cataracts.
Purpose:
To compare visual acuity outcome in two groups of children who underwent congenital cataract surgery. The first group is one in which an isolated cataract occurred; the second group is one in which cataract occurred in conjunction with a systemic disease.
Methods:
A review of 46 charts: 36 children (50 eyes) with congenital cataract as an isolated defect, and 10 children (16 eyes) with cataract as part of a systemic disease.
Results:
One third of the eyes with isolated cataract had postoperative visual acuity better than 6/12, although none of the patients in the syndrome group had visual acuity better than 6/12. This difference was statistically significant (p = 0.01). Of the various ocular pathologies associated with congenital cataract, only nystagmus was found to be more prevalent in the syndrome group (40%) as compared with the isolated cataract group (11%) (p = 0.05). Surgery was performed during the first 2 years of life in 54% of the eyes in the isolated cataract group, and in 87% of the eyes in the syndrome group (p = 0.01). There was no difference in the prevalence of the postoperative complications between the two groups.
Conclusion:
Children who underwent congenital cataract surgery developed poorer visual acuity if the cataract was a part of a systemic disease as compared with children without a systemic syndrome.
