ESCRS - PO389 - Visual Axis Opacification After Pediatric Cataract Surgery- An Analysis Of Morphology And Etiology

Visual Axis Opacification After Pediatric Cataract Surgery- An Analysis Of Morphology And Etiology

Published 2024 - 42nd Congress of the ESCRS

Reference: PO389 | Type: Free paper | DOI: 10.82333/j5c5-tm17

Authors: Lekha Chandel* 1 , sudarshan khokhar 2 , deeksha rani 2 , aishwarya rathod 2 , amar pujari 2

1PGIMER Chandigarh,chandigarh,India, 2R P Centre AIIMS new delhi,new delhi,India

Purpose

To investigate the morphological types and to delineate the clinical and surgical variables associated with VAO in children undergoing pediatric cataract surgery

Setting

Dr. Rajendra Prasad centre for ophthalmic sciences AIIMS ,New delhi

Methods

We included 33 eyes of 28 children who developed clinically significant visual axis opacification (VAO) after congenital or developmental cataract surgery. All eyes underwent a comprehensive examination under anaesthesia (EUA) followed by a membranectomy to clear the visual axis. We classified VAO into three subgroups: fibrotic, proliferative, and combined morphologies. We reviewed and analyzed the retrospective data and the findings during membranectomy to identify the etiological variables associated with various morphologies of VAO.  

Results

The median age at primary surgery was 7 (2-96) months. The median interval from primary surgery to the first documentation of VAO was 6 (1-22) months. Younger children developed VAO sooner than older children. VAO was fibrotic in 11 eyes (33%), proliferative in 18 eyes (54.5%), and combined in 4 eyes (12.12%). Most children with fibrotic VAO belonged to economically disadvantaged sections of society (p=0.04).  

Conclusions

Lower age at primary surgery was the predominant risk factor for the development of VAO. Meticulous surgery, with primary posterior capsulotomy and adequate anterior vitrectomy, adherence to postoperative anti-inflammatory medications is essential to prevent the occurrence of VAO. A close follow-up facilitates early detection and management that can prevent the onset of visually impairing amblyopia.