Congenital And Infantile Cataract: Intraoperative And Early Postoperative Complications Rate After Lensectomy, With Or Without Iol Implantation, In A South Italy Patient Group.

To evaluate the intra-operative and post-operative complication rate of children who had lensectomy due to congenital/infantile cataract. The focus of the review being a comparison of our real life data in a group of south Italy patients with the literature review complication rate, as weel as their further surgical procedures performed.

Retrospective review of patients records with visually significant congenital/infantile cataract who had lensectomy, with or without IOL lens implantation, performed at AORN Santobono Pausilipon, in Naples, between November 2022 and November 2024.

Patients were divided in two different groups according to age (over or under 24 months), so patients under 24 months had lensectomy, with posterior capsulorhexis and anterior vitrectomy without IOL implantation while lensectomy with IOL implantation was performed in second group with older children. All surgical and post-surgical complication were reported and data were compared with literature review through no parametric statistical analysis. Esclusion criteria are traumatic cataract, and others eye conditions could be associated with cloudiness of lens like ROP or Familial exudative vitreoretinopathy. 

46 eyes of 32 patients were reviewed. 14 eyes in first group (mean age 3.78 +/- 2.3 months), where one patients with microphthalmos had further glaucoma surgery in both eyes, 14.2%, 1 eye had retinal detachment, 7.1%, and 2 eyes capsular phimosis enlargment needed, 14.2%. 32 eyes had lensectomy with IOL implantation (mean IOL power +26.5 D +/-2D). The incidence of PCO was 25% (8 eyes), mean incidence time 8.6 months +/- 2.2. Inflammatory reaction with fibrin in the anterior chamber was reported in 4 eyes (12.5%). Other reported complications are: zonular dialysis 1 eye (3.3%), retinal dialysis 1 eye (3.3%), AC hemorrhage 1 (3.3%). PCO was treated by ND:Yag laser specifically designed for the supine position, no complications were reported.

Based on our data collected, real life incidence of intra-operative and post-operative complications after lensectomy in patients with congenital/infantile cataract is similar with literature data (42% vs 37%). Secondary high eye pressure as well as PCO are the main surgical complications seen in the two groups. Our PCO rate outcome is higher (25%) as consequence of our surgical planning, since specific ND:Yag laser (Meridian Nd:YAG Laser MRQ YAG Supine) has been available in our hospital, we can avoid posterior capsulorhexis and anterior vitrectomy in older children where IOL implant is performed and their related complications like vitreous prolapse.