Pediatric Cataract Surgery Risk Score: An Easy Tool for a Better Analysis of Surgical Outcomes

Abstract

Better Analysis of Surgical Outcomes Dany M. Najjar MD; Temple University, Philadelphia, PA Introduction: The research on the success rates of pediatric cataract surgery is ongoing, especially with the increased interest in intraocular lens implantation in newborns. However, most studies overlook inherent factors that increase the risk of surgical complications. High-risk cases should be analyzed separately as they might negatively affect surgical outcomes. Methods: To present a simple method to assess the risk of each pediatric cataract surgery. Results: A number is attributed to each of the individual variables that increase the risk of surgery, such as, age at surgery, cataract type (eg, posterior polar, traumatic), microphthalmia, posterior fetal vasculature, glaucoma, corneal opacities, previous intraocular surgery, associated systemic anomalies (eg, rubella), and history of uveitis or infection. These numbers are then added to obtain the surgical risk score. Discussion: The score can vary from 1 to 15, with values between 1 and 4 considered low risk for complications, between 5 and 9 moderate risk, and above 10 high risk. Success rates for cataract surgery can then be determined for each category. The scale can also be modified to include additional risk factors, or the weight of each factor adjusted according to the surgeon’s experience. Conclusions: This method allows a better analysis of the outcomes of pediatric cataract surgery in research studies. It is also helpful for teaching residents and fellows, and in the preoperative evaluation and family counseling.