Cataract surgery in children with retinopathy of prematurity (ROP): surgical outcomes

Abstract

Cataracts may develop in children with ROP regardless of the modality of intervention. Postoperative complications and refractive changes are similar to those in eyes without ROP.

Outcome of Cataract Surgery in Patients Treated for Retinopathy of Prematurity

“…Because pediatric patients, in our experience, have greater postoperative inflammation, longer and more frequent use of topical steroids is often necessary after cataract surgery to reduce the incidence of synechiae. [12]. In our study, no patients developed a retinal detachment after surgery, but one patient with a history of treated retinal detachment did progress to phthisis 4.4 years after cataract extraction.…”

“…Cataracts can be challenging to treat in patients who have been treated for retinopathy of prematurity due to anatomic changes from previous laser or vitrectomy surgery [12]. The average incidence of pediatric cataracts in patients who have had ROP laser treatment ranges from 0.003% -6% [13] Anatomic changes from prior vitreoretinal surgery can make cataract extraction challenging as well.…”

Cataract Associated with ROP and Other Retinal Pathologies

“…The incidence of ROP in these preterm babies has increased due to an increased survival rate of preterm and poor health care regulations regarding neonatal care and screening guidelines. These preterm low birth weight babies are also at risk to have cataract and an incidence of 0.97-1.9% is seen in these preterms [3,4]. These lenticular opacities can lead to difficulty in assessment of the posterior segment status and management of same.…”

“…In a premature child, cataract can form because of the systemic status, retinopathy of prematurity or due to treatment of same. Cataract development is seen at different duration ranging from 10 days to 13 months in laser-treated and 2 months to 5.6 years in post-vitrectomised eyes [3,4,[13][14][15]. Pathophysiology of cataract in ROP can be divided according to the etiology:…”

“…Also until now, there is no level I evidence of the ocular, visual, systemic and neurodevelopmental safety profile of anti-VEGF in these babies. less frequent as compared to pars plana vitrectomy in adults [3,13,14]. The lens retina approximation is one of the risk factors for cataract formation because of the probability of lens touch.…”