Visual outcomes and complications in infantile cataract surgery: a real - world scenario

Chattannavar, Goura; Badakere, Akshay; Mohamed, Ashik; Kekunnaya, Ramesh

doi:10.1136/bmjophth-2021-000744

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…12 Visual axis opacification is the most common complication following paediatric cataract surgery. [13][14][15][16][17] In Choudhary S et al 2017 9 it was present in 75% of eyes, which did not undergo PPC, developed PCO while only 11.76%, which underwent PPC, developed PCO. In our study it was seen in 36% of cases which did not undergo PPC develop PCO.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the visual outcome of paediatric cataract surgery: A hospital based prospective study in tertiary eye care

Rawate,

Hota,

Dulani

2024

IJCEO

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The aim of this study is to evaluate the various factors affecting the visual outcome of paediatric cataract surgery. Paediatric cataract is a huge problem of the world specially for developing and poor countries. Without treatment cataract can damage connection between brain and eye. So importance of early diagnosis and treatment can prevent permanent vision loss in children.Cataract in children can appear in variety of forms, each presenting in differencing in different way depending on the time. Sometime cataract associated with other ocular disease like coloboma, nystagmus, microphthalmos. These conditions are associated with poor prognosis. So proper visual rehabilitation of neuro- ophthalmic axis is crucial for good visual prognosis. All patients from 2 - 14 years of age who underwent cataract surgery in Department of Ophthalmology at BRLSABVMM College Rajnandgaon during 1- year period were included in the study. Detail history of patient, preoperative examination, ocular and systemic co-morbidity, intraoperative complications and post-operative outcome were documented and analysed. 25 patients underwent cataract surgery during this period.16 were male (64%) and 9 females (36%). Most common presenting symptom is diminution of vision in some cases nystagmus and strabismus also present. In some patient there is history of trauma also present. There was significant improvement in best corrected visual acuity following surgery in approx. 70% of patients. Visual axis opacification is most common complication after that fibrin reaction is other complication.: Improvement in vision in post operative paediatric cataract surgery due to early detection by parents and raise awareness by health workers of rural and urban area. Good visual outcome is depended on good infrastructure for operation theatre, advance microscope with instrument, advance cataract surgery with posterior capsulotomy and anterior vitrectomy, post-operative management and visual rehabilitation.

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Section: Resultsmentioning

confidence: 99%

Factors affecting the visual outcome of paediatric cataract surgery: A hospital based prospective study in tertiary eye care

Rawate,

Hota,

Dulani

2024

IJCEO

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“…The 1-year results of this cohort are reported by the authors previously. [ 9 ] Of 97 patients who were operated, 94 (96.9%), 91 (93.8%), 65 (67.0%), and 79 (81.4%) followed up at 1 week, 1 month, 6 months, and 1 year, respectively. The mean age at surgery was 23.7 weeks (median: 18.7 weeks and interquartile range [IQR]: 11–33.9 weeks).…”

Section: Resultsmentioning

confidence: 99%

“…The study design, the baseline patient demographic details, the preoperative evaluation techniques, surgical techniques, factors influencing IOL implantation, choice of IOL, postoperative eye care regime, patching and optical correction regimens, and postoperative evaluation methods have been reported previously along with visual and refractive outcomes and complications at 1 year after infantile cataract surgery. [ 9 ] Eyes that satisfied the preoperative criteria of an axial length ≥16.5 mm and a horizontal corneal diameter ≥10.5 mm, in the absence of anterior segment dysgenesis and glaucoma, were implanted with an IOL in the bag (AcrySof SA60AT, Alcon Laboratories, Inc, Fort Worth, Tx USA). [ 10 ] The IOL power was calculated using the Sanders–Retzalff–Kraff II/T formula with Enyedi’s guidelines for under-correction.…”

Section: Methodsmentioning

confidence: 99%

Myopic shift, refractive, and visual outcomes after 5 years of infantile cataract surgery: Our experience and review of literature

Gupta,

Ramteke,

Chattannavar

et al. 2024

Taiwan Journal of Ophthalmology

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PURPOSE: After infantile cataract surgery, axial elongation, induces a myopic shift that cannot be fully compensated by corneal flattening and the rate is unpredictable owing to the non-linear growth of the eye. The current prospective study assesses the myopic shift and visual outcomes in children undergoing cataract surgery in infancy over a follow-up period of 5 years. MATERIALS AND METHODS: A prospective study conducted at a tertiary eye care center to evaluate the five-year myopic shift, refractive and visual outcomes in infants, who underwent surgery for congenital cataract in infancy. The visual acuity, myopic shift and biometric changes are compared between the aphakia and pseudophakia group. RESULTS: The mean best-corrected visual acuity (BCVA) recorded in logMAR at 5 years for aphakia group was 0.92±0.44 and for pseudophakia group was 0.66±0.42. (pvalue: 0.002102). The myopic shift was noted to be -5.9+/-5.16 in the aphakia group whereas it was -9.01+/- 3.11 in the pseudophakia group (P value= 0.002101) at 5 years after surgery for infantile cataract. CONCLUSION: IOL implantation in eyes of infants undergoing cataract surgery is feasible in eyes that strictly satisfy the pre-operative inclusion criteria and the visual outcomes in these eyes are better compared to aphakia group at 5 years follow up. Eyes with primary IOL implantation had a higher myopic shift compared to ones without primary IOL implantation. Eyes undergoing primary IOL implantation, need higher under correction compared to the current available formulae.

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“…In recent years, there has been a debate about intraocular lens implantation in children younger than 2 years, and several studies concerning this issue have been performed (e.g. Chattannavar et al., 2022, Infant Aphakia Study Group, 2010, Solebo et al., 2015). The 5‐year results of the IOLunder2 study (Solebo et al., 2018), where primary IOL implantation was performed in 88 of 158 eyes (56%) in children under 2 years of age, showed that implantation had no advantage in terms of visual outcome or glaucoma risk but carried a significantly increased risk of VAO requiring surgery under general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of visual axis opacification in the Swedish Pediatric Cataract Register

Magnusson,

Gyllén,

Haargaard

et al. 2024

Acta Ophthalmologica

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PurposeTo report on the occurrence of postoperative visual axis opacification (VAO) in children younger than 5 years of age operated for cataract in Sweden, and to analyse correlations with age at surgery and surgical method.MethodsData were derived from the Swedish Pediatric Cataract Register (PECARE). All children operated on between 1 January 2007 and 31 December 2020 were included. Follow‐ups at 1, 2 and 5 years of age were analysed.ResultsCataract surgery were performed on 770 eyes belonging to 549 children (n = 282 boys, 51.4%); 327/770 (42.5%) of the children underwent surgery before 3 months of age and 216/770 (28%) before 6 weeks of age. Data on 881 follow‐up visits were registered. At the follow up‐visits at 1, 2 and 5 years of age, VAO was present in 154/349 (44.1%), 41/323 (12.7%) and 25/208 (12%). The majority of the children with VAO underwent cataract surgery before age 6 months, with a predominance before age 2 months. Primary IOL was implanted in 601/770 (78%) of eyes; 40.8% had an acrylic one‐piece lens, 31.8% had a bag‐in‐the‐lens IOL, 21.9% were aphakic and 5.2% had an acrylic three‐piece lens. Implantation of a bag‐in‐the‐lens IOL was related to a significantly lower occurrence of VAO compared to other types of IOL, including aphakia (p < 0.0002).ConclusionOur results are in accordance with the literature. Primary bag‐in‐the‐lens IOL implantation before 2 years of age seems adequate and safe, with a low occurrence of VAO, and can thus be continued as routine in Sweden.

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Visual outcomes and complications in infantile cataract surgery: a real - world scenario

Cited by 6 publications

References 29 publications

Factors affecting the visual outcome of paediatric cataract surgery: A hospital based prospective study in tertiary eye care

Factors affecting the visual outcome of paediatric cataract surgery: A hospital based prospective study in tertiary eye care

Myopic shift, refractive, and visual outcomes after 5 years of infantile cataract surgery: Our experience and review of literature

The prevalence of visual axis opacification in the Swedish Pediatric Cataract Register

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