Abstract
BackgroundCongenital cataracts are often complicated by anterior segment dysgenesis. This study aims to compare bilateral anterior segment parameters, macular thickness, and best-corrected visual acuity (BCVA) in pediatric cataract patients at 3 months after unilateral cataract extraction with intraocular lens implantation.MethodsFifty-three pediatric patients with uncomplicated unilateral total cataracts were included. At 3 months post-surgery, bilateral corneal thickness at the thinnest location (CTTL), anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured using Pentacam. Central macular thickness (CMT) was evaluated using spectral-domain optical coherence tomography. BCVA was measured by experienced optometrists concurrently. Descriptive statistics and bivariate corrections were performed to analyze the interocular differences in bilateral anatomic parameters and their relationships with BCVA.ResultsFor all 53 included patients (mean age 5.2 ± 2.3 years), the median BCVA was 10/40 in the operated eyes and 40/40 in the contralateral eyes, which indicates a significant interocular difference. BCVA values in the contralateral eyes were significantly correlated with patient age at surgery, but this result differed for BCVA in the operated eyes. The Pentacam analysis revealed no significant interocular differences in bilateral CTTL and ACV, but significant differences were found for ACD.ConclusionsAt 3 months after surgery, unilateral pediatric cataract patients exhibited no significant interocular differences in identified anatomical parameters (except for ACD), and these parameters were not significantly correlated with BCVA in bilateral eyes. Therefore, amblyopia, but not anatomical factors, might be the main cause of interocular visual functional differences in our study population.Trial registrationClinicalTrial.gov, NCT02765230, 05/05/2016, retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0371-5) contains supplementary material, which is available to authorized users.
Highlights
Congenital cataracts are often complicated by anterior segment dysgenesis
We found no significant interocular differences in our identified anatomical parameters, with the exception of anterior chamber depth (ACD), and all identified anatomical parameters were not significantly correlated with bilateral best-corrected visual acuity (BCVA)
We found that the mean Central macular thickness (CMT) value in the operated eyes was reduced compared with the contralateral eyes, the differences were not significant; these findings are consistent with the study by Kim et al To date, it has been difficult to predict the prognosis of BCVA among pediatric patients with uncomplicated unilateral cataract
Summary
Congenital cataracts are often complicated by anterior segment dysgenesis. This study aims to compare bilateral anterior segment parameters, macular thickness, and best-corrected visual acuity (BCVA) in pediatric cataract patients at 3 months after unilateral cataract extraction with intraocular lens implantation. Great advances have been made in managing pediatric cataracts during the last several decades; these advances have contributed to a decrease in the incidence of postoperative complications and improvement in visual outcomes [1, 2]. Screening and timely surgical intervention play a key role in improved best-corrected visual acuity (BCVA) among pediatric patients with cataracts, determining the prognosis for an individual remains difficult, for unilateral cataract [8,9,10]. Congenital cataracts are often reported to be complicated with anterior segment dysgenesis. With the exception of the cloudy lens in unilateral uncomplicated cataract patients, it remains unknown whether interocular
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