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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Congenital cataract in microphthalmic eyes: surgery plus genetic evaluation

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Session Details

Session Title: Presented Poster Session: Congenital Cataract Surgery

Session Date/Time: Saturday 10/09/2016 | 09:30-10:50

Paper Time: 09:30

Venue: Poster Village: Pod 1

First Author: : D.Borroni ITALY

Co Author(s): :    K. Bajracharya   I. Orube   E. Elksnis   K. Ozols   M. Ferronato   A. Zemitis

Abstract Details

Purpose:

Congenital cataract rappresents 25% to 30% of avoidable blindness in children and microphthalmus has been found in 7% to 17% of these patients. We reported the outcomes and complications of congenital cataract surgery plus Intraocular-Lens(IOL) implantation in Microphthalmic eyes. The aims of the surgery are to decrease amblyopia, strabisums and give a full visual development to visual system. In Microphthalmic eyes IOL implantation is more challenging due to small anatomy but it gives better visual prognosis than eyes left aphakic. SOX2 gene has been identified as a major causative gene of microphthalmus. Screening of SOX2 was performed.

Setting:

Riga Stradins University – Latvija

Methods:

This study involved 20 microphthalmic eyes from 14 children younger than 3 years of age with congenital cataract. Surgery consisted in aspiration of the lens and IOL implantation. Eyes with inflammation, ocular trauma, aniridia, chorioretinal coloboma or vitreo-retinal diseases were excluded. 6 patients had bilateral cataract. The outcome measures were Intraocular Pressure (IOP), Best-Corrected Visual Acuity (BCVA) intraoperative and postoperative complications. Genomic DNA was extracted from blood. SOX2 coding region was amplified and PCR product were sequenced with Big Dye Terminator v3.1 (Applied Biosystems, Foster City, CA). Initially identified changes were confirmed by additional independent PCR and sequencing experiments.

Results:

At the time of surgery the mean age was 23.9 ± 1.7 months. Mean ocular axial length was 18.6 ± 0.7 mm. Mean preoperative IOP was 9.3 ± 1.2 mmHg and 10.8 ± 2.7 mmHg on final follow­up. No one intraoperative complications happened. Postoperative complication hapened in one eye (the shortest one with 17.9mm of axial lenght) who developed secondary visual axis opacification. Preoperative and postoperative BCVA was 2.01 ± 0.89 logMAR and 0.31 ± 0.06 logMAR in bilateral cases and 1.81 ± 0.97 logMAR and 0.32 ± 0.13 logMAR in unilateral cases, respectively. SOX2 mutations appear in 3/14 cases (15%).

Conclusions:

Primary IOL implantation in congenital cataract surgery for microphthalmic eyes resulted in a significant BCVA improvement with minimal postoperative and no intraoperative complications. Glaucoma and axial opacifications are well knowed long term postoperative complications and children who underwent congenital cataract surgery must be followed-up regularly. Shorter axial lenght is a significat risk factor for post-operative complicatons. SOX2 mutation is found to be one of the major causes of microphthalmus and further studies of mutations affecting the lens membranes (aquaporins/Mip, Lim-2 or connexins) or the structural proteins of the cytosol will give a better uderstanding of congenital cataracts in developing eyes.

Financial Disclosure:

NONE

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