Purpose:
To evaluate the long-term visual outcome and to determine the surgical complications after cataract surgery in patients with unilateral childhood cataract.
Material and Method:
We retrospectively reviewed the records of 18 cases with unilateral childhood cataract who had undergone cataract surgery before the age of seven. Primary intraocular lens (IOL) implantation was made in children who were older than 1 year of age. Secondary IOL implantation was made after 18 months in children who were operated before the age of 1 year and were left aphakic. Occlusion therapy was performed to all children for amblyopia postoperatively. Visual acuity and complications were evaluated in a mean follow-up period of 4.8 years.
Results:
The mean age of the 18 patients (9 female/9 male) at the time of surgery was 43.6±33.7(1-84) months. Eleven (61%) patients had cataract surgery after 1 year of age. Secondary IOL implantation was performed at mean 28th month in 4 of 7 aphakic patients (57%) who had cataract surgery before one year of age. In 3 (43%) aphakic patients, secondary IOL implantation could not be performed because of ocular pathologies such as microophthalmia. Final visual acuity was 0.5 or better in 7 eyes (39%), between 0.1 and 0.5 in 6 eyes (33%), and worse than 0.1 - in 5 eyes (28%). Of 5 eyes that had visual acuity worse than 0.1, 4 (80%) had at least one additional ocular pathology such as microphthalmia, strabismus and nystagmus. Nd:YAG laser posterior capsulotomy was performed at mean 8th month in 7 of 8 (87%) children whose posterior capsules were left intact at surgery.
Discussion:
Favorable visual outcomes can be achieved with surgical intervention and complementary amblyopia treatment in children with unilateral cataract. Preoperative microphthalmia, nystagmus and strabismus are not entirely an obstacle to visual development, but they are important factors leading to low visual acuity. (Turk J Ophthalmol 2012; 42: 103-10)
Keywords: Childhood cataract, unilateral cataract, cataract surgery