Long-Term Visual Outcomes In Patients With Delayed Congenital Cataract Surgery

Published 2023 - 41st Congress of the ESCRS

Reference: FP25.03 | Type: Free paper | DOI: 10.82333/ygdk-yb36

Authors: Elif Akbaş Ulman* ¹ , Elif Demirkilinc Biler ¹ , Onder Uretmen ¹

¹Ophthalmology,Ege University Faculty of Medicine,Izmir,Türkiye

Purpose

To evaluate the long-term visual prognosis and additional eye problems in patients with delayed congenital cataract surgery in the first year of life.

Setting

The data of congenital cataract patients who underwent delayed cataract surgery at a referral center were evaluated retrospectively.

Methods

The medical records of patients, who underwent delayed cataract surgery (in unilateral cataracts; 8 weeks and after, in bilateral cataracts; 12 weeks and after) in the first year of life and followed for at least three years were reviewed. Patients with additional ocular pathology, other types of cataracts due to metabolic, radiation, and traumatic etiologies and patients who were not able for visual expression at the last visit were excluded from the study. Statistical relationship between findings were evaluated.

Results

89 eyes of 52 patients (26 female, 26 male) were included in the study. 15 of the patients had unilateral and 37 had bilateral congenital cataracts. The mean age at cataract surgery of unilateral patients was 6.80±4.13 (range, 2.0-12.0) months, whereas the mean age at cataract surgery of bilateral patients was 5.18±2.13 (range, 2.5-12.0) months. After cataract surgery, patients were followed for an average of 108.3±51.9 (range, 37-265) months. The BCVA of the patients at the last follow-up was significantly worse in eyes with unilateral cataracts (p= <.001). A total of 37 (41.6%) eyes underwent secondary IOL implantation. Glaucoma was developed in 46 (51.7%) eyes. Strabismus development was more common in the unilateral group (p=.03).

Conclusions

Surgery at an early age is critical in the visual development of cases with congenital cataracts, and patients with unilateral cataract have a lower visual prognosis and a higher development of strabismus. On the other hand, there is a chance to obtain functional vision with appropriate refractive correction and occlusion treatment, even in delayed surgeries and unilateral cases.