Cataract Surgery in the Second Decade of Life: Outcomes and Cataract Characteristics
Leah Bonaparte, MD, MSCR; Rupal Trivedi, MD, MSCR; Sarah Logan, MD; M. Edward Wilson, MD
Storm Eye Institute, Medical University of South Carolina
Charleston, South Carolina
Introduction: Few studies have investigated the characteristics and management of cataracts of older children. This study explores the features of cataract and outcomes of surgery in patients from the ages of 10-20.
Methods: Retrospective study investigating the characteristics of cataract and surgical outcomes of consecutive patients from age 10-20 operated on by a single surgeon.
Results: A total of 148 eyes of 101 patients were included. Median age at time of surgery was 13.7 years, and at time of last follow-up, 17.3 years. Fifty-three percent were female, and 61% of the study cohort was of Caucasian descent. Sixty-four precent of eyes were left with an intact posterior capsule, 6% PCCC without vitrectomy and 30% with posterior capsulectomy and vitrectomy. Ninety-eight percent of eyes had a primary intraocular lens placed, and 97% were placed within the capsular bag. A fourth of eyes left with an intact posterior capsule developed posterior capsular opacification (PCO), which was, on average, removed 3 years after surgery. Median visual acuity of unilateral cataract was 20/60 and bilateral was 20/25. Postoperatively, one eye had retinal detachment, and three eyes developed ocular hypertension. No patient developed glaucoma.
Discussion: Better visual acuity outcomes occur with bilateral cataract. There is a low complication rate in cataracts operated on from the ages of 10-20.
Conclusion: Visual acuity outcomes were excellent in bilateral cataracts operated in the second decade. Visually significant PCO occurred in a fourth of the eyes with an intact posterior capsule. These data have important implications for cataract surgery in this pediatric population.
- Trivedi RH, Wilson ME, Bandyopadhyay D. Refractive shift in pseudophakic eyes during the second decade of life. J Cataract Refract Surg 2012; 38: 102-107.
2. Wilson ME, Trivedi RH, Burger BM. Eye growth in the second decade of life: implications for the implantation of a multifocal intraocular lens. Trans Am Ophthalmol Soc 2009; 107. 120-126.
3. Repka MX, Dean TW, Lazar EL, Yen KG, Lenhart PD, Freedman SF, Hug D, Rahmani B, Wang SX, Kraker RT, Wallace DK; Pediatric Eye Disease Investigator Group. Cataract surgery in children from birth to less than 13 years of age; baseline characteristics of the cohort. Ophthalmology. 2016 Dec;123(12):2462-2473.