Surgical, medical and developmental outcomes in patients with Down syndrome and cataracts

Santoro, Stephanie L.; Atoum, Dema; Hufnagel, Robert B.; Motley, William W.

doi:10.1177/2050312117715583

Cited by 11 publications

(5 citation statements)

References 14 publications

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“…Literature shows that patients with Down syndrome are at an increased risk of developing cataract. 19 A significant numbers of children (7.8%) in our study were diagnosed with chromosomal abnormalities, (Down syndrome; 29 patients, Turner syndrome; one). Syndactyly (figure 3) was seen in four patients.…”

Section: Discussionmentioning

confidence: 67%

Etiology of Congenital Cataract in a Tertiary Hospital, Lahore

Qayyum,

Qayyum

2023

pak J Ophthalmol

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Purpose: To identify the etiology of congenital cataracts in a tertiary care center of Lahore. Study Design: Cross-sectional. Sampling Technique: Non-probability purposive sampling. Place and Duration of Study: Department of pediatric ophthalmology The Children’s hospital and Institute of Child Health, Lahore from May 2018-October 2019. .Methods: Children one year and younger diagnosed with congenital cataract were included in the study. A detailed ocular examination was done including B-scan. Blood samples of all the infants were tested for presence of specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies by the enzyme-linked immunosorbent assay (ELIZA). Specific blood tests were done to rule out any metabolic disorder. The children were referred to pediatrician for detailed systemic examination. Data were collected, and statistical analysis was done using Excel (Microsoft 2015, version 15.15) and Stata (version 13). Results: A total of 384 infants were included in the study. Mean age of the patients was 5.9 ± 5 months. No cause could be identified in 39.06% and familial pattern was seen in 28.12%. Consanguinity was seen in all familial cases. Rubella was found to be the causative agent in 17.7% participants of the study. Associated ocular problem was seen in 89 (23.17%) infants and microphthalmia being the most frequent. Developmental delay was seen in 126 (6.7%) children. Conclusion: Congenital cataract represents a complex and challenging ophthalmic condition that may result in significant visual impairment. Early identification and timely intervention are pivotal for achieving a positive visual outcome.

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Section: Discussionmentioning

confidence: 67%

Etiology of Congenital Cataract in a Tertiary Hospital, Lahore

Qayyum,

Qayyum

2023

pak J Ophthalmol

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“…Postoperative complications encountered in the studied group were compared with data reported in other studies on pediatric patients with and without Down syndrome (Table 3) [15][16][17].…”

Section: Resultsmentioning

confidence: 99%

Clinical and therapeutic particularities of congenital cataracts in pediatric patients with Down syndrome

Voinea

Tătaru

Sima³

2020

rjo

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Objective: This study aims to identify clinical and therapeutic surgical particularities and postoperative complications encountered in children suffering from Down syndrome and congenital cataract, as well as the existence of a correlation with associated systemic anomalies. Methods: A retrospective interventional study that analyzes cases of congenital cataracts operated on a group of 14 children with Down syndrome, respectively on 26 eyes, was performed. The age of the children at the time of the surgery, the presence of associated ocular and systemic anomalies, the employed surgical technique, the frequency and the type of postoperative complications, were examined. Results: Cataracts present at birth, with recommendations for surgical treatment, were rare among children suffering from Down syndrome, but their frequency increased with age. Most children had systemic anomalies, but also other, usually multiple, ocular anomalies. The rate of postoperative complications was higher than among children with congenital cataracts, but without Down syndrome. In six cases, more than one complication/ case was identified. It was not possible to establish a clear correlation between the number and type of the postoperative complication and the systemic anomalies, nor was it possible to establish a correlation with the functional visual outcomes, because those children had other important ocular anomalies as well. Conclusions: Congenital cataracts with recommendations for surgical treatment in children suffering from Down syndrome have a low incidence, but an increase in frequency can be noticed with age. The recommended surgical technique is the one that involves maneuvers for the prevention of visual axis re-opacification. Per primam implantation is definitely indicated. The risk of postoperative complications is high, in terms of both frequency and number, with the possibility that more than one complication occurs, unrelated to a particular systemic anomaly, in one patient.

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“…This difference in surgical outcomes between children with DD and the general pediatric population could be secondary to more medically complex cases, susceptible anatomy, or difficult post-surgical course. Higher rates of cataract surgery complications in children with DD correlate with the increased morbidity for this group from surgical interventions outside of ophthalmology as well [3].…”

Section: Discussionmentioning

confidence: 99%

“…Higher rates of complications in children with DD are consistent with existing literature, which states surgical complications in children with Trisomy 21 occur in 20% -60% of patients compared to 0% -28% of the general pediatric population. However, existing studies were limited by small sample size [3]. This difference in surgical outcomes between children with DD and the general pediatric population could be secondary to more medically complex cases, susceptible anatomy, or difficult post-surgical course.…”

Section: Discussionmentioning

confidence: 99%

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

Panneerselvam¹,

Chilakapati²,

Moisiuc³

et al. 2021

OJOph

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Background: Childhood cataract causing visual impairment can compound developmental delay (DD) if left untreated. Current literature in children with DD is limited; thus, we evaluated cataract etiology, challenges, and treatment compliance in this group. Purpose: To report the presentation and challenges associated with cataract management in children with developmental delay (DD) at a tertiary care pediatric hospital. Methods: Retrospective review of 100 patients (173 eyes) presenting with cataracts and DD from February 2014 to December 2017. Results: 100 patients (173 eyes) were included. 27 patients had unilateral cataracts and 73 bilateral. The average age was 120.55 months (SD 63.77, range 5.87 -243.16); the average follow-up period was 57.7 months (SD 139.14, range 1.03 -1412.30). 61% of patients (55% eyes) underwent medical management for cataracts due to: cataract was not visually significant (66% eyes), parent deferred surgery (11% eyes), self-abusive behavior (14% eyes), and medical conditions that limited visual recovery (9% eyes). 32% of patients were unable to perform objective visual acuity by age 5. Patients with self-abusive behavior were more likely to present with or develop retinal detachment (RD) (35%) compared to those without self-abusive behavior (6%) (p = 0.0028). A statistically significant difference in the difficulty of examination (p < 0.0001) and poor compliance of glasses wear (p < 0.0001) was found in nonverbal patients. Surgical complications occurred in 39% of eyes. Those with intraocular lens placement after cataract extraction were more likely to develop visual axis opacification (27% eyes) than those who remained aphakic (9% eyes) (p = 0.0313). Conclusion: Cataract extraction in pediatric patients with DD can be associated with success, however, providers should prepare for limitations in managing these patients.

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Surgical, medical and developmental outcomes in patients with Down syndrome and cataracts

Cited by 11 publications

References 14 publications

Etiology of Congenital Cataract in a Tertiary Hospital, Lahore

Etiology of Congenital Cataract in a Tertiary Hospital, Lahore

Clinical and therapeutic particularities of congenital cataracts in pediatric patients with Down syndrome

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

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