Outcome Of Pediatric Cataract Removal Without Primary Intraocular Lens Implantation Via Pars Plana Versus Via Clear Corneal Incision
Published 2023 - 41st Congress of the ESCRS
Reference: FP25.02 | Type: Free paper | DOI: 10.82333/tzy6-r950
Authors: Dominik Knebel* 1 , Oliver Ehrt 1 , Claudia Priglinger 1 , Günther Rudolph 1 , Siegfried Priglinger 1
1Department of Ophthalmology,University hospital, LMU Munich,Munich,Germany
Purpose
To compare the postoperative outcomes of pediatric cataract removal without primary intraocular lens (IOL) implantation via pars plana (PPL) versus via clear corneal incision (CCI).
Setting
Department of Ophthalmology at the University Hospital of Ludwig-Maximilians-University (LMU) in Munich, Germany.
Methods
Retrospective chart review of n=28 eyes. PPL was performed in 15 eyes, CCI in 13 eyes. Surgery included lens removal, posterior capsulotomy and anterior vitrectomy in all cases. The PPL and CCI groups were compared with regard to age at surgery, ocular comorbidities, intra- and postoperative complications and postoperative corrected distance visual acuity (CDVA).
Results
Median age at surgery was 46 days in the PPL group and 54 days in the CCI group. Ocular comorbidities were present in 20% of eyes in the PPL group and 53.8% in the CCI group. Median follow-up was 3.3 years in the PPL group and 3.0 years in the CCI group. In the PPL group, 20% had intraoperative complications, compared to none (0%) in the CCI group (p=0.110). Visual axis obscuration (VAO) occurred in 40% of eyes in the PPL group and in 38.5% in the CCI group (p=0.914). Secondary glaucoma occurred in 7 of 15 eyes (46.7%) in the PPL group compared to 2 of 9 eyes (22.2%) without preoperatively diagnosed glaucoma in the CCI group (p=0.161). Median postoperative logMAR equivalent CDVA was 0.5 in the PPL group and 0.3 in the CCI group (p=0.087).
Conclusions
Secondary VAO occurred at equal rates in both groups. Although statistical significance was not reached for any of the comparisons, several other complications were observed less frequent in the CCI group compared to the PPL group, most notably intraoperative complications and secondary glaucoma. Postoperative CDVA was also better in the CCI group. However, interpretation of the data is limited by the retrospective design of our study and the small cohort. Large scale prospective evaluations are needed to compare the available surgical techniques of paediatric cataract removal in different age groups.