Artikel
Congenital cataract: postoperative functional results
Suche in Medline nach
Autoren
Veröffentlicht: | 22. September 2004 |
---|
Gliederung
Text
Objective
Congenital cataract develops within the ninth to tenth week of fetal period. It occurs with a frequency of 2-5 per 10000 children. The pathogenesis is influenced by many different factors and only in 50 % of the diagnosed cases the cause is known. Congenital cataracts have to be diagnosed as early as possible to decide if and when a surgery is indicated. Aim of our study was to evaluate the most common type of cataract, "best" age to do surgery, complications and functional outcome after treatment of congenital cataract.
Methods
The medical records of 54 infants who underwent surgery for unilateral (24) and bilateral (30) congenital cataract during a fifteen-year-period were analysed retrospectively. The follow-up period ranged from 3 to 60 months with a mean period of 15 months. Success was measured according to the vision attained and occurrence of adverse events.
Results
The cause of cataract was discovered in 55% of the patients. The most common type of cataract was cataracta polaris posterior and zonularis (66%). Ophthalmic surgery was done at the age of two months up to 16 years. The interval between both eyes in infants with bilateral cataract ranged from 0 to 18 months. In all cases a lens extraction was done via corneoscleral or limbal cut with or without capsulotomy and anterior vitrectomy depending on standard at the time of surgery. In 36 eyes an intraocular lens was implanted. Intraoperative complications were observed in 8 eyes, early postoperative complications in 12 eyes. 48 eyes showed late postoperative complications. Complication rate was highest in children younger than 12 months at the time of surgery. We found an improved visual acuity in 82 eyes (97,6%) after surgical treatment. During follow-up time the children showed a function of <0,1 (31%), 0,1-0,5 (34%) and ≥0,5 (35%).
Conclusions
Complications requiring additional surgery are very common in infants who were operated because of congenital cataracts during the first year of life. Good levels of VA were achieved only in children who underwent cataract surgery within the first year of life and who adhered to the occlusion therapy schedule. In 60% of all cases included in the study we found satisfactory postoperative functional results but the possible visual acuity that can be achieved can be limited by amblyopia. Therefore it is very important to do an amblyopia prophylaxis before as well as after surgery.