Reoperation Incidence, Timing And Determinants After Congenital Cataract Surgery: A 10-Year Retrospective Study

To determine the incidence, timing and determinants of reoperation following congenital cataract surgery.

Department of Ophthalmology, Istanbul University, Faculty of Medicine, Istanbul, Türkiye.

This retrospective cohort study was conducted at a tertiary referral center between 2016 and 2026. Medical records of patients undergoing congenital cataract surgery were reviewed. Demographic characteristics, baseline ocular findings, surgical techniques, postoperative complications and reoperation data were collected and analyzed. Categorical variables were compared using chi-square and Fisher–Freeman–Halton exact tests where appropriate. Time-to-event outcomes were assessed with Kaplan–Meier survival analysis. Statistical significance was defined as p < 0.05.

Fifty-eight eyes (35 patients) were included. Primary surgery was lensectomy with anterior vitrectomy alone (56.9%) or with ciliary sulcus IOL implantation(43.1%).Reoperation occurred in 55.2%(multiple: 40.6%). Leading indications were anterior vitrectomy (34.4%), secondary IOL implantation (18.8%), IOL repositioning(18.8%) and strabismus surgery(15.6%). Multiple reoperations were more frequent before 6 months of age (47.4% vs 30.8%). Eyes without primary IOL had higher rates of glaucoma(18.2% vs 12.0%) and synechiae(12.1% vs 0%), while nystagmus and strabismus rates were similar between groups (Fisher exact test, p=0.122). Kaplan–Meier showed median time to reoperation 5 months(95% CI 2.2–7.8) and 48% reoperation-free survival at 5 months.

Reoperation was frequent, affecting more than half of eyes and a substantial proportion required multiple procedures. Early surgery (before 6 months of age) was associated with a higher burden of repeated interventions. Secondary vitreous and IOL-related procedures were the predominant drivers of reintervention. Although overall complication patterns did not differ significantly by surgical approach, eyes without primary IOL showed numerically higher rates of glaucoma and synechiae. Kaplan–Meier analysis demonstrated that reoperations clustered within the first postoperative months, underscoring the need for intensive early surveillance and sustained long-term follow-up.