Abstract
Purpose To determine and to analyze the outcome of pediatric cataract surgery. Methods A retrospective chart review of individuals aged up to 10 years who underwent cataract surgery between January 1, 2004, and December 31, 2014, at the UniversityHospital Zurich, Switzerland. Results 63 children (94 affected eyes) with bilateral (68/94) or unilateral (26/94) cataract were identified. Surgery was performed at a median age of 1.5 months (IQR: 1.3–2.6 months) for the aphakic group (45/94) and of 50.7 months (IQR: 38.0–78.4 months) for the IOL group (49/94). At the last follow-up visit (median 31.1 months, IQR: 18.4–50.2 months), visual acuity was better in bilateral than in unilateral cataract cases. Posterior capsular opacification (PCO) was diagnosed in 30.9% of eyes without a significant difference in the IOL and aphakic groups (p = 0.12). Aphakic glaucoma was diagnosed in 12/45 eyes at a median of 6.8 months (IQR 2.1–13.3 months) after surgery. Microcornea (5/12) and anterior segment anomalies (8/12) were associated with glaucoma development (p < 0.05). Conclusion Laterality and timing of surgery influence the outcome of pediatric cataract surgery. PCO was the most frequent postoperative complication. Aphakic glaucoma is often associated with ocular developmental abnormalities and a poor visual outcome.
Highlights
Congenital cataract is the main reason for preventable blindness in children worldwide, with a prevalence of 3 to 4 per 10,000 children in Europe [1, 2]
Aphakic glaucoma is often associated with ocular developmental abnormalities and a poor visual outcome
The long-term outcome of pediatric cataract surgery depends on multiple factors, for example, age at first presentation of cataract and age at surgery, associated ocular anomalies, and development of aphakic glaucoma [6, 7]
Summary
Congenital cataract is the main reason for preventable blindness in children worldwide, with a prevalence of 3 to 4 per 10,000 children in Europe [1, 2]. Cataracts in children are mostly congenital, acquired cataracts (e.g., following ocular trauma) are relatively common [3, 4]. Etiology of congenital or acquired childhood cataract includes ocular abnormalities, ocular trauma, intrauterine infections, associated syndromes, or hereditary causes [5]. The long-term outcome of pediatric cataract surgery depends on multiple factors, for example, age at first presentation of cataract and age at surgery, associated ocular anomalies, and development of aphakic glaucoma [6, 7]. A variety of factors determines the likelihood of a successful functional and morphological outcome after pediatric cataract surgery. According to Wu et al, the treatment of congenital cataract patients is among the most difficult and cost-intensive interventions in ophthalmology [1]
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