Unplanned returns to the operating room within three months of pediatric cataract-related intraocular surgery: indications and risk factors

Abstract

To evaluate the indications and associated risk factors for unplanned returns to the operating room within 90days of pediatric cataract-related surgery. The medical records patients undergoing either cataract extraction or secondary intraocular lens (IOL) implantation at a single center from 1991 to 2018 were reviewed retrospectively. A total of 1,392 eyes of 989 patients were included, with 48 unplanned reoperations in 46 eyes of 43 patients, yielding a reoperation rate of 3.3% (46/1392) for one reoperation and 0.14% (2/1392) for two within 90days of surgery. Of the 48 reoperations, indications for reoperation were as follows: lens cortex reproliferation (n=14), elevated intraocular pressure (n=11), inflammatory pupillary membranes (n=7), vitreous wick to the cataract surgery wound (n=6), synechiae (n=3), uveitis (n=3), posterior capsule opacification in an eye with intact posterior capsule (n=1), retained cortex (n=1), traumatic iris prolapse (n=1), and foreign body in anterior chamber (n=1). Risk factors for an unplanned reoperation included a history of traumatic cataract (relative risk, 2.55) or age <1year at time of first surgery (relative risk, 3.02). In the absence of these risk factors, the reoperation rate was 1.1%. Unplanned reoperations after pediatric cataract surgery are uncommon, but when they occur it is often in the setting of trauma or surgery performed before the age of 1year.