Analysis of age at detection and outcomes of dense unilateral congenital cataract surgery for children on the paediatric cataract register

Abstract

Aim: Analysis of age at time of detection and surgery of dense unilateral cataract and investigation of best-corrected visual acuity (BCVA) in a nationwide register-based cohort study, based on the routine of maternity ward eye screening.Methods: Data were derived from the Paediatric Cataract Register (PECARE). All children (n = 54) diagnosed with dense congenital unilateral cataract between January 2007 and September 2014 who had surgery before 1 year of age, and for whom 5year follow-up records were available, were included. Results:The majority, 35/54 (65%), were detected and operated on before age 6 weeks and 30/35 (86%) were referred from maternity wards. Visual acuity (VA) ≥ 0.5 (decimal, 0.3 logMAR) was found in 7/53 (13%) of the cohort at age 5 years; further, 19 children achieved VA ≥ 0.1 (decimal, 1.0 logMAR) (36%) and 19 children VA < 0.05 (decimal, 1.30 logMAR) (36%). Ten-year follow-up records were available for 17/53 (32%) children; 1/17 (6%) achieved VA ≥ 0.5 (decimal, 0.3 logMAR), 4/17 (24%) VA ≥ 0.3-<0.5 (decimal, 0.52-0.30 logMAR), 3/17 (18%) VA ≥ 0.05-0.1 (decimal, 1.30-1.0 logMAR) and 10/17 (59%) VA < 0.05 (decimal, 1.30 logMAR). Conclusion:A total of 90% of the children were detected with cataract within 100 days of birth and 80% were operated on within this period. This study showed better visual acuity in those treated for dense unilateral cataracts than previously reported in an earlier Swedish cohort study.

Multifocal intraocular lens implantation in children with unilateral congenital cataracts

“…In addition, 69.09% achieved VA better than 0.3 (logMAR), which is much higher than that in previous studies with monofocal IOL implantation. 3,15–17 The multifocal IOL used in this study (ZMB00) has a near addition of +4.0 D, which not only provides good distance vision but also significantly improves DCIVA (0.39 ± 0.15) and DCNVA (0.44 ± 0.15) to varying degrees compared with preoperative values.…”

“…In addition, 69.09% achieved VA better than 0.3 (logMAR), which is much higher than that in previous studies with monofocal IOL implantation. 3,[15][16][17] The multifocal IOL used in this study (ZMB00) has a near addition of +4.0 D, which not only provides good distance vision but also significantly improves DCIVA (0.39 ± 0.15) and DCNVA (0.44 ± 0.15) to varying degrees compared with preoperative values. This study also observed that the cataract eyes often exhibits a greater corneal astigmatism (1.64 ± 1.00 D) compared with the contralateral eyes in children with unilateral congenital cataracts.…”

Issue highlights

“…The variants did not seem to contribute to the pathogenesis of SIDS. 6 The authors analysed age at the time of detectionandvisualacuityat5and10 yearsofage.Thestudyshowed better visual acuity in those treated for dense unilateral cataracts than an earlier Swedish cohort study.…”

“…Congenital cataracts are the most common cause of treatable blindness in children worldwide. Wackerberg et al studied Swedish children diagnosed with dense unilateral congenital cataracts who had surgery before 1 year of age between 2007 and 2014 6 . The authors analysed age at the time of detection and visual acuity at 5 and 10 years of age.…”

Patching in Children With Unilateral Congenital Cataract and Child Functioning and Parenting Stress

“…3 However, many children who are born with a UCC never achieve good vision in their affected eye. 4,5 For example, in the Infant Aphakia Treatment Study (IATS), approximately 25% of children achieved a visual acuity (VA) of 20/40 or better, and 44% had VA of 20/ 200 or worse. 4 Both unsuccessful treatment of UCC and no treatment result in poor vision in the affected eye, but occlusion therapy has the potential to harm children.…”