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Surgical outcomes of early versus late surgery for congenital cataract in eyes with microcornea

Poster Details

First Author: H.Matalia INDIA

Co Author(s):    J. Matalia   N. Kasturi           

Abstract Details



Purpose:

Cataract surgery in eyes with microcornea is technically difficult due to small and maybe hazy cornea, shallow anterior chamber, poor pupillary dilatation and persistent tunical vasculosis lentis. In this study we wish to report the clinical profile and post-operative outcomes of congenital cataract surgery in eyes with microcornea and compare between early vs. late surgery.

Setting:

Narayana Nethralaya, a tertiary eye care center and teaching institute, Bangalore, India.

Methods:

In this interventional comparative study, we retrospectively reviewed patients with microcornea (corneal diameter of less than 10 mm) and congenital cataract, who underwent lens aspiration with primary posterior capsulectomy and anterior vitrectomy below 1 year of age. Demographic profiles, systemic and ocular features were documented. Patients were divided into 2 groups, early and late, depending on age at time of surgery (below and above 3 months). Preoperative evaluation included measurement of horizontal corneal diameter, intraocular pressure, axial length, keratometry and morphology of cataract. Post operative complications were analysed as transient (<1 week) and late in both groups.

Results:

Forty-two eyes of 24 patients were analysed. Early group consisted of 21 eyes with mean follow up of 20.12 months while late group had 21 eyes with mean follow up of 15.61 months. The mean age at surgery was 2.24 months for the early group and 6.81 months for the late group. The average corneal diameter was 9.07 mm for the early group and 8.43 for the late group. Nineteen children (79.16%) had heart disease and 5 children had developmental delay (20.83%). Associated ocular features included microphthalmos (30 eyes-71.42%), salt and pepper retinopathy (22 eyes-52.38%), nystagmus (11 patients-26.19%), squint (5 patients-11.9%), persistent posterior primary vitreous (2eyes-4.76%). Postoperative complications included transient corneal edema (4 eyes-17%), secondary glaucoma (1eyes-4%) and postoperative fibrinous uveitis (4 eyes-173%). Intraoperatively all the cases had poor dilatation with two cases requiring iris hooks. Post-operatively, transient corneal edema was seen in 4 patients in early group and 3 patients in late group. Visual axis opacification was noted in 2 cases in each group while secondary glaucoma developed in 1 eye in early and in 2 eyes in late group.

Conclusions:

No significant difference was noted between the two groups as regards intraoperative and postoperative complications. Good surgical outcomes can be expected in cases of congenital cataract with microcornea irrespective of the age at surgery. FINANCIAL INTEREST: NONE

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