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Bilateral congenital cataract surgery outcomes in eyes with and without microcornea

Poster Details

First Author: N.Solmaz TURKEY

Co Author(s):    F. Önder   G. Koca           

Abstract Details



Purpose:

To investigate in cases with congenital and developmental cataract the effects of the presence of microcornea on visual outcomes and complications.

Setting:

Department of Ophthalmology, Haseki Training and Research Hospital, Istanbul, Turkey

Methods:

The records of the patients operated between 1998 and 2012 for bilateral congenital and developmental cataract were reviewed retrospectively. Forty-six cases ( 12 years or younger at the time of surgery ) with minimally one-year post-operative follow up were included in the study. Those cases with micropthalmia, persistent fetal vasculature (PFV) and congenital glaucoma were excluded. The selected cases were divided into two groups with and without microcornea and were compared on the bases of age at primary surgery, presence of ocular and systemic anomalies, intraocular lens implantation, visual outcomes and complications using the Mann-Whitney U Test, taking the p < 0.05 value as statistically significant.

Results:

Group I consisted of the 26 eyes of 13 cases with microcornea , while group II included 66 eyes of the 33 cases with normal corneal diameter. In cases with microcornea, the corneal diameter varied between 8 and 10 mm. Statistical differences were not found between group I and group II with respect to the age at surgery ( 29.4±32.6 vs 32.7±41.1 months, respectively ) and the follow-up periods ( 77.2±56.5 vs 53.2±35.7 months, respectively ). The incidence of systemic pathology was not different in the two groups. Nystagmus was present in 77% of the group I and 33% of the group II cases (p<0.001); and, while 55% of the group I cases were aphakic, 75% of the group II cases were pseudophakic (p<0.005). The mean best corrected visual acuity (BCVA) was 1.0±0.7 logMAR and 0.75±0.9 logMAR in the group I and group II, respectively (p<0.05). About 60 % of the cases in group II and only 25 % of the cases in group I had 0.3 logMAR or good BCVA. The most important complication was secondary glaucoma and it was observed in 42.3 % of group I and 16.7 % of the group II cases (p<0.05).

Conclusions:

High incidence of nystagmus in patients with microcornea is restrictive to restoration of visual acuity and leaving most of the cases aphakic complicates visual rehabilitation. Also, the increased risk of secondary glaucoma threatens vision in the long term, therefore requiring lifelong close follow up of the patient. FINANCIAL INTEREST: NONE

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