CONGENITAL CATARACT: HOW TO MANAGE POST-OPERATIVE INFLAMMATION?

Published 2024 - 28th ESCRS Winter Meeting

Reference: FP12 | Type: Submission | DOI: 10.82333/wj0a-xn34

Authors: Sarah Houti* ¹ , Zineb Morchid ¹ , zineb Hammoumi ¹ , Ghizlane Daghouj ¹ , Loubna Elmaaloum ¹ , Bouchra Allali ¹ , Asmaa Elkettani ¹

¹Ophtalmology,University hospital Ibn Rochd,Casablanca,Morocco

Purpose

Identify the factors responsible for postoperative inflammation of congenital cataract surgery and their management pre, peri and postoperative.

Setting

This is a retrospective descriptive study over a period of 18 months from January 2021 to June 2022, carried out within the Pediatric Ophthalmology Department in 20 Aout hospital. It includes 88 patients.

Methods

Demographic information, including gender, age, laterality, and morphology, was obtained from each patient. All patients underwent an ophthalmic evaluation, including a sedated examination, B-mode ultrasound, and biometrics. Surgery was performed by an experienced pediatric surgeon in all patients and using a well-standardized technique

Results

Our series involved 126 operated eyes in 88 children; the average age of our patients was 1 year and 5 months, with a proportion of 54% boys. The occurrence of inflammation is around 25.4%. All our patients received a preoperative preparation based on mydriatic agent, NSAIDs Non-steroidal anti-inflammatory drug and CTC eye drops. The pupillary dilatation was generally good in almost 82% or improved intraoperatively by intracameral injection of adrenaline and viscodilatation . The implantation was intrasaccular in most of our patients, almost 84%. Vitrectomy was used for all our patients as well as a postoperative treatment. The occurrence of inflammation according to gender and laterality is not statistically significant with a ratio close to 1. The occurrence of inflammation was also noted in about 62 % of patients implanted in the capsular bag; 28 % in the sulcus and 9 % in the aphakic.

Conclusion

For a better prognosis in congenital cataract surgery, it is essential to properly control postoperative inflammation by managing its occurrence factors. Good preoperative preparation, less manipulation of the iris, implantation in the sac and postoperative care are necessary to control inflammation. The experience of the surgeon remains a key element in the success of this challenge which is only the beginning of a long process of care.