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Li L, Wang X, Liu C, Wang S, Wang X. Incidence Rate of Secondary Glaucoma Following Congenital Cataract Surgery: An In-Depth Systematic Review and Meta-Analysis. Am J Ophthalmol 2024; 265:176-188. [PMID: 38679355 DOI: 10.1016/j.ajo.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE To assess the incidence of secondary glaucoma in children following congenital cataract surgery. DESIGN Systematic review and meta-analysis. METHODS The PubMed, Embase, Cochrane Library, and Web of Science databases were searched from inception through March 16, 2023. Studies reporting congenital cataract surgery and glaucoma were enrolled. The quality of the selected studies was assessed using the Newcastle Ottawa Scale, and data analysis was executed utilizing R software. RESULTS A total of 36 published studies with 3151 patients (4717 eyes) were included in the analysis. The incidence rate of glaucoma following congenital cataract surgery was 6.6% (95% CI: 3.9%, 9.9%). The incidence of secondary glaucoma in the primary intraocular lens (IOL) implantation group (3.3% [95% CI: 1.5%, 5.8%]) and the secondary IOL implantation group (3.5% [95% CI: 0%, 11.4%]) were lower compared to the aphakia group (13.5% [95% CI: 7.7%, 20.6%]). The incidence rate among children with congenital cataracts from Asia (6.9% [95% CI: 4.1%, 10.4%]) was higher than that in European children (0.9% [95% CI: 0%, 3.0%]; P < .01). A correlation was identified between the age at cataract surgery and the incidence of secondary glaucoma (P = .02). CONCLUSIONS This meta-analysis found that the incidence of secondary glaucoma following congenital cataract surgery is approximately 6.6%. Children with IOL implantation exhibit a lower incidence of secondary glaucoma, with a lower incidence noted in European children compared to their Asian counterparts. The age at cataract surgery is an important risk factor to consider.
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Affiliation(s)
- Li Li
- Department of Ophthalmology, Zaozhuang Municipal Hospital (L.L.), Zaozhuang, Shandong, China
| | - Xi Wang
- From the Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University (X.W., C.L., S.W., X.W.), Dalian, Liaoning, China
| | - Changyang Liu
- From the Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University (X.W., C.L., S.W., X.W.), Dalian, Liaoning, China
| | - Shuai Wang
- From the Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University (X.W., C.L., S.W., X.W.), Dalian, Liaoning, China.
| | - Xiaochen Wang
- From the Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University (X.W., C.L., S.W., X.W.), Dalian, Liaoning, China.
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Kooshki AM, Kooshki AM, Yaseri M, Nouri L, Alipour F. Experiences of Treatment With Contact Lenses in Aphakic Children With Unilateral Congenital Cataract: A Retrospective Study. Eye Contact Lens 2022; 48:222-227. [PMID: 35333798 DOI: 10.1097/icl.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Congenital cataract is a condition compromising the eye's crystalline lens in infants and is usually diagnosed at birth. It can lead to irreversible vision loss if not promptly detected and treated, especially in unilateral cases. Nowadays, children with congenital cataracts can undergo surgical removal of their opacified crystalline lenses, and visual rehabilitation is mandatory to prevent deep amblyopia. Contact lenses, predominantly of rigid gas-permeable (GP) type, are gaining more popularity for this matter. METHOD In this retrospective cohort study, unilateral aphakic children younger than 6 years referred to the Contact Lens Clinic at Farabi Eye Hospital from November 2011 to September 2019 were included. RESULTS Seventy-six unilateral aphakic children with congenital cataracts (57.9% boys and 42.1% girls) rehabilitated with GP were studied. The mean age of diagnosis and referral to the contact lens clinic were 20.0±19.8 and 32.0±24.4 weeks, respectively, while the mean follow-up time was 12.44±26.28 months. The mean visual acuity for children capable of cooperating at the last follow-up was 0.98±0.62 log MAR. Among the participants, eight children (9.7%) were diagnosed as glaucoma suspects. The mean initial base curve and power of GP lenses were 7.86±0.39 mm and 23.29±5.52 diopters, respectively. Only 21 parents (27.6%) reported nonadherence to the scheduled part-time patch program. CONCLUSION The results of this study showed GP-based optical treatment after early diagnosis, surgical removal of congenital cataracts, and a long-term close follow-up to be well tolerated by children and their parents, with acceptable parents' compliance and can thus be introduced as a safe and effective method to achieve desirable visual outcomes.
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Affiliation(s)
- Abdolreza M Kooshki
- Department of ophthalmology (A.M.K., A.M.K., L.N.), Eye Research Center, Farabi Eye Hospital Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics (M.Y.), School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of ophthalmology (F.A.), Eye Research Center, Farabi Eye, Tehran, Iran
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Nyström A, Haargaard B, Rosensvärd A, Tornqvist K, Magnusson G. The Swedish National Pediatric Cataract Register (PECARE): incidence and onset of postoperative glaucoma. Acta Ophthalmol 2020; 98:654-661. [PMID: 32274899 DOI: 10.1111/aos.14414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim was to report cumulative incidence and time of onset of postoperative glaucoma in a paediatric early cataract surgery cohort. METHODS Data were retrieved from the Pediatric Cataract Register (PECARE), a prospective register of Swedish cataract operations before 8 years of age. All eyes with surgery between January 2007 and December 2014 and a registered follow-up were included. Cataracts caused by uveitis, trauma or coexisting congenital glaucoma were excluded. Glaucoma was defined as early onset if diagnosed within a year after surgery and late onset if diagnosed later. RESULTS The study included 288 eyes in 207 children (106 girls), 81 with bilateral and 126 with unilateral cataracts, with a mean follow-up of 3.31 ± 1.77 years. Of the 288, 168 (58.3%) had surgery before 3 months of age; most of these 92.3% (155/168) were defined as dense, 208 (72.2%) were below 1 year of age. Cumulative incidence of surgically treated glaucoma among individuals was 23.7% (49/207). Median time to glaucoma onset was 0.91 years (range: 0.05-4.97 years) for eyes. Early-onset glaucoma was found in 98 % (63/64), and late onset in 2% (1/64). CONCLUSION In this paediatric cataract cohort, a majority of eyes had surgery before 3 months of age (58.3%). Secondary glaucoma-onset peaked within the first postoperative year, with a cumulative incidence of 23.7%. Surgery performed after the first month of life, resulted in a lower glaucoma rate. Long-term follow-up will reveal whether the low rate of late-onset glaucoma with early surgery will last, and if so, the consequences.
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Affiliation(s)
- Alf Nyström
- Department of Ophthalmology Region Västra Götaland Sahlgrenska University Hospital Mölndal Sweden
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | | | - Annika Rosensvärd
- Division of Ophthalmology and Vision Department of Clinical Neuroscience Karolinska Institute St Erik Eye Hospital Stockholm Sweden
| | - Kristina Tornqvist
- Department of Clinical Sciences Ophthalmology Lund University Lund Sweden
| | - Gunilla Magnusson
- Department of Ophthalmology Region Västra Götaland Sahlgrenska University Hospital Mölndal Sweden
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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Sourav S, Bottari D, Shareef I, Kekunnaya R, Röder B. An electrophysiological biomarker for the classification of cataract-reversal patients: A case-control study. EClinicalMedicine 2020; 27:100559. [PMID: 33073221 PMCID: PMC7548424 DOI: 10.1016/j.eclinm.2020.100559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Untreated congenital blindness through cataracts leads to lasting visual brain system changes, including substantial alterations of extrastriate visual areas. Consequently, late-treated individuals (> 5 months of age) with dense congenital bilateral cataracts (CC) exhibit poorer visual function recovery compared to individuals with bilateral developmental cataracts (DC). Reliable methods to differentiate between patients with congenital and developmental cataracts are often lacking, impeding efficient rehabilitation management and introducing confounds in clinical and basic research on recovery prognosis and optimal timing of surgery. A persistent reduction of the P1 wave of visual event-related potentials (VERPs), associated with extrastriate visual cortical activity, has been reported in CC but not in DC individuals. Using two experiments, this study developed and validated P1-based biomarkers for diagnosing a history of congenital blindness in cataract-reversal individuals. METHODS Congenital and developmental cataract-reversal individuals as well as typically sighted matched controls took part in a first experiment used for exploring an electrophysiological biomarker (N CC = 13, N DC = 13, N Control = 26). Circular stimuli containing gratings were presented in one of the visual field quadrants while visual event-related potentials (VERPs) were recorded. Two biomarkers were derived from the P1 wave of the VERP: (1) The mean of the normalized P1 amplitude at posterior electrodes, and (2) a classifier obtained from a linear support vector machine (SVM). A second experiment with partially new CC/DC individuals and their matched controls (N CC = 14, N DC = 15, N Control = 29) was consecutively used to validate the classification based on both biomarkers. Performance of the classifiers were evaluated using receiver operating characteristic (ROC) curve analyses. All cataract-reversal individuals were tested after at least one year of vision recovery. FINDINGS The normalized P1 amplitude over posterior electrodes allowed a successful classification of the CC from the DC individuals and typically sighted controls (area under ROC curve, AUC = 0.803 and 0.929 for the normalized P1 amplitude and the SVM-based biomarker, respectively). The validation for both biomarkers in experiment 2 again resulted in a high classification success (AUC = 0.800 and 0.883, respectively for the normalized P1 amplitude and the SVM-based biomarker). In the most conservative scenario involving classification of CC from DC individuals in a group of only cataract-reversal individuals, excluding typically sighted controls, the SVM-based biomarker was found to be superior to the mean P1 amplitude based biomarker (AUC = 0.852 compared to 0.757 for the mean P1 based biomarker in validation). Minimum specificity obtained was 80% across all biomarkers. INTERPRETATION A persistent reduction of the P1 wave provides a highly specific method for classifying cataract patients post-surgically as having suffered from bilateral congenital vs. bilateral developmental cataracts. We suggest that using the P1 based non-invasive electrophysiological biomarker will augment existing clinical classification criteria for individuals with a history of bilateral congenital cataracts, aiding clinical and basic research, recovery prognosis, and rehabilitation efforts. FUNDING German Research Foundation (DFG) and the European Research Council (ERC).
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Affiliation(s)
- Suddha Sourav
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
- Corresponding author.
| | - Davide Bottari
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
- IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Idris Shareef
- Jasti V Ramanamma Children's Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Ramesh Kekunnaya
- Jasti V Ramanamma Children's Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Brigitte Röder
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
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Wang J, Jin L, Lu Q, Borah RR, Ali R, Li J, Chakraborti C, Kumar M, Pan J, Gilbert C, Congdon N. Barriers, Costs, and Attitudes Toward Pediatric Cataract Surgery at Two Large Facilities in China and India. Ophthalmic Epidemiol 2018; 26:47-54. [PMID: 30142020 DOI: 10.1080/09286586.2018.1513043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To better understand barriers of costs and attitudes toward pediatric cataract surgery in China and India. METHODS From January 2014 to June 2015, families of children ≤ 10 years old about to undergo or having completed surgery for bilateral, non-traumatic cataract at two tertiary centers in China and India completed questionnaires regarding their demographic characteristics, financial status, living environment, health seeking behaviors, and medical burden. RESULTS In China, 38 children (23 boys [60.5%], mean age 3.11 ± 2.88 years) were un-operated, and 44 (26 boys [59.1%], mean age 5.09 +/- 2.17 years) had undergone surgery, while in India there were 60 (44 boys [73.3%], mean age 4.61 +/- 3.32 years) and 39 (29 boys [74.4%], mean age 6.45 +/- 2.74 years) children respectively, 181 in total. Chinese children were younger at presentation (p ≤ 0.03 for both operated and un-operated) and also when cataract was detected (median [inter quartile range] 10 [3-34] versus 24 [6-60] months [p = 0.06] for un-operated, 5 [2-12] versus 36 [8-72] months [p < 0.001] for operated). Maternal education levels were lower in India (48.3% and 51.3% with elementary education only among un-operated [p = 0.11] and operated [p = 0.006] families in India versus 27.0% and 20.5% in China), as were rates of consulting medical practitioners for illness (44.7% and 36.4% for un-operated [p < 0.001] and operated [p = 0.001] in China versus 10% and 5.13% in India). CONCLUSIONS Socioeconomic challenges to securing cataract surgery may be greater, and delays in obtaining surgery longer, in India compared to China, if these facilities are representative.
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Affiliation(s)
- Jun Wang
- a Division of Preventive Ophthalmology, State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , Guangdong , China
| | - Ling Jin
- a Division of Preventive Ophthalmology, State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , Guangdong , China
| | - Qing Lu
- b Orbis International , New York , NY , USA
| | | | - Rahul Ali
- b Orbis International , New York , NY , USA
| | - Junhong Li
- c Translational Research for Equitable Eyecare , Shanxi Eye Hospital , Taiyuan , Shanxi , China
| | - Chandni Chakraborti
- d Department of Epidemiology , Vivekananda Mission Asram Netra Niramay Niketan , Purba Medinipur , West Bengal , India
| | - Manish Kumar
- d Department of Epidemiology , Vivekananda Mission Asram Netra Niramay Niketan , Purba Medinipur , West Bengal , India
| | - Jessica Pan
- e Department of Epidemiology, Mailman School of Public Health , Columbia University , New York , NY , USA
| | - Clare Gilbert
- f Department of Clinical Research, International Centre for Eye Health (ICEH) , London School of Hygiene & Tropical Medicine , London , UK
| | - Nathan Congdon
- a Division of Preventive Ophthalmology, State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , Guangdong , China.,b Orbis International , New York , NY , USA.,g Translational Research for Equitable Eyecare, Center for Public Health , Queen's University Belfast, Royal Victoria Hospital , Belfast N , Ireland
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Solebo AL, Hammond CJ, Rahi JS. Improving outcomes in congenital cataract. Nature 2018; 556:E1-E2. [PMID: 29620728 DOI: 10.1038/nature26148] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 01/23/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Ameenat Lola Solebo
- Lifecourse Epidemiology and Biostatistics Section, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK..,Great Ormond Street Hospital/Institute of Child Heath NIHR Biomedical Research Centre, London, UK.,Moorfields Eye Hospital and Institute of Ophthalmology NIHR Biomedical Research Centre, London, UK.,Ulverscroft Vision Research Group, University College London Institute of Child Health, London, UK
| | - Christopher J Hammond
- King's College Hospital London, Academic Section of Ophthalmology, School of Life Course Sciences, Faculty of Life Sciences and Medicine, St Thomas's Hospital Campus, London, UK
| | - Jugnoo S Rahi
- Lifecourse Epidemiology and Biostatistics Section, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK..,Great Ormond Street Hospital/Institute of Child Heath NIHR Biomedical Research Centre, London, UK.,Moorfields Eye Hospital and Institute of Ophthalmology NIHR Biomedical Research Centre, London, UK.,Ulverscroft Vision Research Group, University College London Institute of Child Health, London, UK
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Rajavi Z, Mokhtari S, Sabbaghi H, Yaseri M. Long-term visual outcome of congenital cataract at a Tertiary Referral Center from 2004 to 2014. J Curr Ophthalmol 2016; 27:103-9. [PMID: 27239587 PMCID: PMC4881158 DOI: 10.1016/j.joco.2015.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 11/02/2015] [Indexed: 12/11/2022] Open
Abstract
Purpose To assess the long-term visual acuity (VA) outcome after congenital cataract surgery at Imam Hossein Medical Center (Tertiary Referral Center) (2004–2014). Methods In this descriptive study, records of 120 patients with a history of congenital cataract surgery were studied. Those with traumatic, metabolic cataract, aged <5 years at the last visit who were not able to respond VA testing accurately and follow-up < 6 months were excluded. Cases with incomplete files were recalled and reexamined. Finally, the records of 42 patients (71 eyes) were included. Results In this study, 20 males and 22 females with a mean age of 11.80 ± 6 years at their last visit were studied. Bilateral and unilateral cataract was seen in 69% and 31% of cases, respectively. Posterior and anterior subcapsular opacity was the most common (53.70%) and rarest (1.90%) type of congenital cataract, respectively. The mean age at the time of operation and surgical interval was 65 ± 66.6 (range: 1–200) and 12.9 ± 23.5 (range: 0–96) months, respectively. The most common method of refractive error correction was pseudophakia plus glasses (56.3%) with the mean best corrected visual acuity (BCVA) of 0.29 ± 0.28 LogMAR., The mean BCVA was 0.7 ± 0.53 LogMAR for aphakic patients correcting by glasses. In our study, amblyopia (56%), glaucoma (23.90%), and posterior capsular opacity (16.40%) were observed during their follow-ups on an average of 76 ± 65 months (median: 60, range: 6–240). Unilateral cataract, aphakia, nystagmus, female gender, and strabismus were risk factors of VA loss. Conclusion Based on our results, 56% of cases showed amblyopia. It could be due to late operation (especially in unilateral cases), longer surgical interval between two eyes, and no compliance of amblyopia therapy. Early detection through screening may reduce the rate of amblyopia. Refractive errors, visual acuity, amblyopia, glaucoma, posterior capsular opacity, and compliance of amblyopia therapy should be checked regularly at follow-up visits.
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Affiliation(s)
- Zhale Rajavi
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Mokhtari
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Sabbaghi
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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Hussain AHME, Hossain A, Ferdausi N, Islam MZ, Sen U. Visual Outcomes of Congenital Cataract Surgery in a Tertiary Public Hospital in Bangladesh. Asia Pac J Ophthalmol (Phila) 2015; 4:263-6. [PMID: 26431209 DOI: 10.1097/apo.0000000000000082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this study was to look at the visual outcomes of bilateral congenital cataract surgery. DESIGN A prospective study was conducted. METHODS A total of 102 eyes of 51 children aged between 2 and 12 months undergoing bilateral congenital cataract surgery from January 2008 to December 2008 with a 3-year follow-up were included in this study. The study was performed at a tertiary public hospital. Data were analyzed using SPSS version 17. Chi-square (χ²) tests were performed to identify the association between visual outcome and age at surgery. P values less than 0.05 were considered statistically significant. RESULTS Among the 102 eyes, 32 (31.4%) eyes were operated on when the subjects were aged between 2 and 3 months, and 70 (68.6%) eyes were operated on at the age of 3 to 12 months. The subjects were followed up for 3 years after surgery. Postoperative best-corrected visual acuity was measured. Visual outcomes were significantly poor in children aged 3 months or older (P < 0.001) as compared with children aged between 2 and 3 months. CONCLUSIONS Early detection and treatment with long-term postoperative rehabilitation is vital to improve visual outcomes of children with congenital cataract.
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Affiliation(s)
- A H M Enayet Hussain
- From the *Department of Pediatric Ophthalmology, National Institute of Ophthalmology and Hospital; and †Green Life Medical College, Dhaka, Bangladesh
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Strabismus in infants following congenital cataract surgery. Graefes Arch Clin Exp Ophthalmol 2015; 253:1801-7. [PMID: 25819919 DOI: 10.1007/s00417-015-2983-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/20/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE This study aimed to determine the incidence and characteristics of strabismus following congenital cataract surgery in infants. MATERIALS AND METHODS Patients aged <12 months who underwent surgery for congenital cataract and were followed-up for ≥1 years were included. Patients that had strabismus prior to surgery were excluded. Data regarding gender, cataract laterality, morphology, and density, age at the time of cataract surgery, ocular motility post surgery, and the presence of nystagmus were retrospectively obtained from the patients' records. RESULTS The study included 79 patients (48 male and 31 female). Unilateral surgery was performed in 14 of the patients, versus bilateral surgery in 65. Strabismus did not occur post surgery in 32 (40.5 %) of the patients (group 1), whereas 47 (59.5 %) (group 2) developed strabismus following surgery. The patients in group 1 were followed-up for a mean 50.7 ± 38.5 months, versus 50.3 ± 39 months in group 2. Mean age at the time of cataract surgery in groups 1 and 2 was 3.6 ± 1.9 years and 4.6 ± 3.2 months respectively. Mean duration of time between cataract surgery and the development of strabismus was 13.3 ± 13 months (range: 1-60 months). Unilateral cases were more prone to develop strabismus, which was statistically significant (p = 0.028). Age at the time of cataract surgery, gender, cataract density, the occurrence of aphakic glaucoma, the presence of nystagmus, and additional ocular surgery were not significantly associated with the development of strabismus. CONCLUSION Strabismus develops more frequently in children undergoing cataract surgery. In the present study strabismus occurred in more of the patients that underwent unilateral surgery. Based on the present findings, we think that long-term careful follow-up to monitor the development of strabismus is required in all infants undergoing cataract surgery, especially unilateral cases.
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Speeg-Schatz C. [Results and complications of surgery of congenital cataract]. J Fr Ophtalmol 2011; 34:203-7. [PMID: 21367487 DOI: 10.1016/j.jfo.2011.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 12/29/2010] [Indexed: 11/25/2022]
Abstract
Results of surgery for congenital cataract were studied according to age of implantation, type and polarity. Each forms combined, visual acuity in logMAR is divided by a median of 0.45 (5/10) in bilateral cataracts and 0.7 (2/10) in the unilateral. The precocity of the surgery allows a better prognosis, but exposes to more complications, especially glaucoma. Complications as inflammatory diseases, glaucoma, capsular opacification, refractive error, residual myopic shift, and retinal complications are discussed.
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Affiliation(s)
- C Speeg-Schatz
- Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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Sjöstrand J, Magnusson G, Nyström A, Jonsson R. Stability of visual outcome from 7 years in children treated surgically for bilateral dense congenital cataracts before 37 weeks of age. Acta Ophthalmol 2011; 89:30-6. [PMID: 19725812 DOI: 10.1111/j.1755-3768.2009.01618.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To study the long-term visual outcome and the age at which final visual acuity can be predicted in a population sample of children treated surgically for bilateral dense congenital cataract before 37 weeks of age. In addition, we assessed the influence of associated risk factors and compared the visual development of these aphakic children with presumably blocked visual input before early surgery to that of normal children in Sweden. METHODS The 18 patients included were followed for at least 10 years postoperatively. The median age at last visit was 15.5 years (range 10-18). The best-corrected visual acuity (BCVA) was tested monocularly with a logarithmically scaled letter acuity test from 4 years of age to late teens. Other registered postoperative data were presence of manifest nystagmus, strabismus and complications. RESULTS The BCVA of the better-seeing eye reached a plateau at 7 years of age. Age at surgery of 80 days or less characterized the majority of cases with a logMAR ≤ 0.3 with a threshold effect between 80 and 130 days of age. Compared to normal children in Sweden, the long-term visual outcome showed a deficit of 0.5-0.6 logMAR. CONCLUSION In spite of optimized care and surgery before 9 months, the BCVA was subnormal in our population compared to healthy children. The long-term visual outcome can be predicted at 7 years of age. Screening with early detection followed by surgery before the end of the third month is important to decrease the risk of marked acuity loss.
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Affiliation(s)
- Johan Sjöstrand
- Department of Ophthalmology, University of Gothenburg, Sweden.
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Park SH, Na JH, Shin SY. Strabismus following bilateral cataract surgery in childhood. Jpn J Ophthalmol 2010; 54:272-7. [DOI: 10.1007/s10384-010-0806-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Accepted: 02/16/2010] [Indexed: 11/30/2022]
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Birch EE, Cheng C, Stager DR, Weakley DR, Stager DR. The critical period for surgical treatment of dense congenital bilateral cataracts. J AAPOS 2009; 13:67-71. [PMID: 19084444 PMCID: PMC3310432 DOI: 10.1016/j.jaapos.2008.07.010] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 06/20/2008] [Accepted: 07/01/2008] [Indexed: 11/27/2022]
Abstract
INTRODUCTION We examined the critical period for deprivation amblyopia in a cohort of patients with dense bilateral congenital cataracts to investigate the optimum timing for surgical treatment. METHODS Thirty-seven infants with dense bilateral congenital cataracts that were extracted by 31 weeks of age were enrolled prospectively. Visual acuity outcome was assessed at >/=5 years of age. We statistically evaluated which of 4 models provided the best fit to the data: (1) no change in visual acuity outcome with delay in surgery, (2) linear decline of outcome with delay, (3) a bilinear model in which a critical age exists after which outcome depends on delay, and (4) a bilinear model in which a critical age exists before which outcome depends on delay. In addition, we reviewed medical records for associated adverse outcomes, including strabismus, nystagmus, secondary membrane formation, and glaucoma. RESULTS A bilinear model with a critical age of 14 weeks fit the data better than a linear model (chi(2) = 14.7; p < 0.0006). During weeks 0-14, mean visual acuity decreased by 1 line with each 3 weeks' delay in surgery. From 14 to 31 weeks, visual acuity was independent the subject's age at surgery, averaging 20/80. Surgery after 4 weeks was associated with a greater prevalence of strabismus and nystagmus than surgery before 4 weeks, whereas surgery during the first 4 weeks was associated with a greater prevalence of secondary membrane formation and glaucoma. CONCLUSIONS We did not find a latent period for the treatment of children with dense bilateral congenital cataracts. Deprivation amblyopia may be minimized with early surgery for bilateral cataracts.
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Affiliation(s)
- Eileen E Birch
- Retina Foundation of the Southwest, Dallas, Texas; Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, Texas
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Lee EJ, Kim JH, Kim SJ, Yu YS. Clinical Manifestations and Surgical Results of Steroid-Induced Cataract in Children. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.12.1923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Hun Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
| | - Seong-Joon Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
| | - Young Suk Yu
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
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Kim DH, Kim JH, Kim SJ, Yu YS. Clinical Results of Secondary Intraocular Lens Implantation in Bilateral Congenital Cataract. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.11.1752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dong Hyun Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Hun Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Joon Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
| | - Young Suk Yu
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
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