Visual Outcomes And Complications At Age 8 In Chinese Children With And Without Visual Axis Opacification Following Cataract Surgery For Congenital Cataracts Performed Between 0-2 Years Of Age

To compare the visual outcomes and complications at age 8 in Chinese children with or without visual axis opacification following congenital cataract surgery performed between 0-2 years of age.

Single center nonrandomized concurrent controlled clinical trial

This study was performed at the Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University. Among 887 Chinese children with congenital cataracts who underwent cataract surgery between 0 and 2 years of age, a total of 129 participants were included in this study, comprising 63 eyes that underwent reoperation for visual axis opacification (VAO) following congenital cataract surgery performed between 0-2 years of age, and 66 eyes that did not develop VAO after congenital cataract surgery during the same age period. Best-corrected visual acuity and ocular complications were compared between the two groups at age 8.

Among the 63 children who underwent reoperation for VAO following congenital cataract surgery at age 0 to 2, 29 were male (46.03%), compared to 35 males (53.03%) in the 66 patients without VAO. At age 8, the BCVA in eyes that underwent reoperation for VAO was significantly lower than that in eyes without VAO (P < 0.01). The mean BCVA at age 8 was 0.6 logMAR (Snellen equivalent, 20/80) in the VAO reoperation group and 0.19 logMAR (Snellen equivalent, 20/50) in the group without VAO. The results indicated that the occurrence of VAO was correlated with age, microphthalmos, and PHPV. The incidence of glaucoma-related adverse events was significantly increased in the group that developed VAO and underwent surgical treatment.

These findings show that the development of severe visual axis opacification following congenital cataract surgery significantly impairs long-term visual development in children, which suggesting that close postoperative follow-up is essential to observe for the occurrence of VAO, particularly in younger patients.