Longterm Outcomes Of Congenital Cataract Surgery In Pediatric Patients With Micropthalmia At Tertiary Referral Hospital

To evaluate long term surgical outcomes of paediatric patients with congenital cataract associated with micropthalmia.

Bursa Uludag University, Faculty of Medicine, Ophthalmology Department

The study included 106 eyes of 62 children with micropthalmia who underwent cataract surgery without primary intraocular lens implantation due to the visually significant cataract  at tertiary referral hospital between 2005 to 2019. Aphakia rehabilitation was done with glasses or contact lens postoperatively. Concomitant systemic and ocular pathologies were recorded. The main outcome measurements were best corrected visual acuity (BCVA), intraoperative and post-operative complications. Patients with a follow-up period of less than 3 years were excluded.

Mean age was 12.4 months and the mean  axial length was 17.9 mm at the time of surgery. Mean follow-up period was 5.1 years. Preoperatively, persistent fetal vasculature was seen in 8 eyes (7.5%), aniridia in 4 eyes (3.8%), iris coloboma in 3 eyes (2.8%), optic nerve hypoplasia in 2 eyes (1.9%), corneal opacity in 6 eyes (5.6%) and microspherophakia in 4 eyes (3.8%). At early postoperative period posterior synechiae with pupillary membrane was observed in 7 eyes (6.6%). At the last follow up glaucoma was seen in 32 eyes (30.2%). Secondary intraocular lens implantation was done in 44 eyes (41.5%) during follow-up. The final BCVA was 0.4 Snellen lines  and 4 eyes (3.8%) had no light perception. Phthisis bulbi was observed in 2 eyes (1.9%).

Anterior and posterior segment dysgenesis and systemic pathologies may have accompanied with microphthalmia. Lens aspiration, posterior capsularhexis and anterior vitrectomy without primary intraocular lens implantation seems to be safe surgical option with acceptable long-term visual outcomes.