Complications after early surgery for congenital cataracts

Abstract

ABSTRACT.Purpose: To study the type and frequency of complications requiring additional surgery in infants operated on for congenital cataract before 12 months of age. Methods: The medical records of 57 infants who underwent surgery for unilateral and bilateral congenital cataracts during a five-year-period were reviewed retrospectively. The follow-up period ranged from 9 to 70 months with a mean of 37 months. Cataract extraction was performed on 83 eyes. Results: Thirty-eight operations for after-cataracts were performed on 32 out of 83 eyes. Fourteen vitrectomies were made on 11 eyes because of pupillary block glaucoma. Glaucoma requiring trabeculectomy developed in eight eyes 2 to 14 months after cataract extraction. This type of glaucoma occurred almost exclusively in eyes operated on during the first two months of life. Conclusion: Complications requiring additional surgery are very common in infants operated on for congenital cataracts during the first year of life. Glaucoma requiring trabeculectomy developed particularly in infants who had their cataract extraction very early. Glaucoma development was not more common in infants operated on for after-cataract.Key words: infant -cataract surgery -complications -aphakic glaucoma -after-cataract.Acta Ophthalmol. Scand. 1999: 77: 677-680 Copyright c Acta Ophthalmol Scand 1999. ISSN 1395-3907 C ataract is the most important cause of treatable childhood blindness (Foster et al. 1997). The visual outcome in infants undergoing surgery for congenital cataract has improved dramatically since the advent of modern surgical techniques and the realisation that early intervention and immediate optical correction can prevent otherwise irreversible deprivation amblyopia (Taylor 1979;Jacobson et al. 1981). However, it is extremely important that the cataract extraction and the correction of aphakia are performed early -within the first months of life Rogers et al. 1981;Gelbart et al. 1982;Parks 1982;Birch & Stager 1988;Drummond et al. 1989;Kugelberg 1992). It is also important to diagnose and treat complications such as after-cataract and secondary glaucoma as soon as possible to avoid deprivation amblyopia or damage of the optic nerve. Both open-angle and closedangle glaucoma occur after successful surgery for congenital cataracts and the incidence remains alarmingly high (Phelps & Arafat 1977;Keech et al. 1989;Simon et al. 1991;Mills & Robb 1994).The aim of this retrospective study was to determine the type and incidence of complications requiring additional surgery in infants who had undergone cataract extraction prior to 12 months of age. Material and MethodsThe medical records of all infants who underwent surgery for congenital cataract before 12 months of age at St. Erik's Eye Hospital during the five-year period from October 1991 to August 1996 were reviewed retrospectively. Seventy-five percent of the operations were performed by the same surgeon, the remaining twenty-five percent by three other surgeons.The surgical technique of the cataract extraction was th...

Advances in the management of congenital and infantile cataract

“…40 A Swedish study of infants undergoing cataract surgery before 12 months found that 10% developed glaucoma severe enough to require surgical intervention. 41 A bimodal onset of glaucoma was observed. An early onset group developed glaucoma within 6 months of surgery associated with angle closure.…”

Implante intra-ocular de lentes dobráveis "piggyback" em paciente portador de catarata congênita no primeiro ano de vida: relato de caso

“…Essas complicações incluíam glaucoma de ângulo aberto ou por bloqueio pupilar, formação de membrana pupilar e corectopia (19)(20) . Além destas, duas outras complicações sabidamente conhecidas do implante de duas ou mais LIOs "piggyback" são: mudanças refracionais e formação de opacificações entre as lentes (13) .…”

Pediatric Cataract

“…Various studies have found glaucoma to be observed in 10-25% of children after paediatric cataract surgery. [68][69][70][71][72][73][74][75] Early age at surgery and presence of microphthalmia are high risk factors. Trivedi et al8 have found the incidence of glaucoma to be comparable between pseudophakic and aphakic eyes.…”