Factors that influence the visual outcome in cases of infantile unilateral cataract

Abstract

Aim: To review retrospectively the records of a cohort of patients who presented before 6 months of age with unilateral cataract and identify factors that influenced the visual outcome. Method: The records of children with unilateral infantile cataract, who had been examined since 1993 following the establishment of a new occlusion protocol, were reviewed. For analysis the children were divided into two groups: group A with visual acuity of 0.6 logMAR or better and group B with visual acuity of Results: Thirty-two children met the inclusion criteria; 8 transferred to other hospitals leaving 24 cases for analysis. There were 11 (46%) children in group A with visual acuity ranging from 0.6 to 0.04 logMAR and 13 (54%) children in group B with visual acuity ranging from NPI, to 0.74 logMAR. The median age at surgery was 8.5 weeks (13 weeks, group A; 7 weeks, group B). There was a greater Incidence of ophthalmic complications in group B. Nystagmus was present in 9 (38%) children, 8 of who were in group B, and this was a significant factor in visual outcome (p = 0.013). Compliance with the occlusion protocol was also a significant factor in visual outcome (p = 0.016). Further analysis indicated an association between occlusion compliance, visual outcome and distance from home (p = 0.035). Conclusion: A high incidence of ophthalmic complications, a delay in establishing daily contact lens wear and a failure to achieve 'good' compliance with occlusion therapy were associated with a poor visual outcome.