Bilateral cataract surgery preserves exceptional visual acuity in toddlers with juvenile cataract
IMAGE: SCHOOL CHILDREN TRYING ON NEW EYEGLASSES THEY RECEIVED THROUGH THE VISION FOR BALTIMORE PROGRAM. view more
CREDIT: JOHNS HOPKINS UNIVERSITY
Bilateral cataract surgery conducted between the ages of 2 and 7 years was linked with considerably fewer adverse events and exceptional visual acuity when compared to babies and toddlers, says an article published in the Journal of American Association for Pediatric Ophthalmology and Strabismus.
Pediatric cataract is the most common cause of juvenile blindness. Untreated childhood cataracts impose a significant social, economic, and emotional impact on the child, family, and community.
Carolina Adams and colleagues conducted this study to compare the results of bilateral cataract surgery in children 2-7 years old at our hospital to the bilateral newborn and toddler results of the Toddler Aphakia Pseudophakia Study (TAPS) registry.
For this study, the medical records of children aged 2 to 7 years who received bilateral cataract surgery with a minimum of 2 years of postoperative follow-up were examined retrospectively. Patients with a history of trauma or with subluxated lenses were not eligible. The primary outcome indicators were best-corrected visual acuity, surgical strabismus, adverse events, and reoperations.
The key findings of this study were as follow:
1. A total of 114 eyes from 57 youngsters were involved in the study.
2. The average age at surgery was 4.4 years.
3. The median best-corrected visual acuity of the better-seeing eye at the visit closest to 10 years of age was 0.05 logMAR (20/22); of the worse-seeing eye, 0.18 logMAR (20/30).
4. One patient underwent strabismus surgery.
5. Adverse events occurred in 4 eyes (7%) of the first-operated eyes, which was considerably lower than the TAPS cohorts of 1-7 months (P = 0.0001) and 7 months to 2 years (P = 0.01).
6. No eye was diagnosed with glaucoma or was designated as a glaucoma suspect.
7. In four of the first-operated eyes, unplanned intraocular reoperations were required.
In conclusion, the authors found that for children aged 2 to 7 years, lensectomy with IOL implantation is preferable to aphakia; also, the effects of this operation are age-dependent.
Reference:
Adams, C., Alex, A. A., Trivedi, R. H., & Wilson, M. E. (2022). Outcomes of bilateral cataract surgery in children 2-7 years of age: a comparison to surgery in toddlers and infants. In Journal of American Association for Pediatric Ophthalmology and Strabismus. Elsevier BV. https://doi.org/10.1016/j.jaapos.2022.02.011
