Factors Affecting Visual Acuity after Unilateral Cataract Extraction in Pediatric Age Group
Sherin H. Sadek Mourad, MD; Ghada I. Gawdat, MD; Shaimaa H. Mostafa, MSc; Mahmoud A. Kamal, MD
Tertiary referral hospital in Egypt “ABO EI Reesh Children Hospital, Cairo University” and Fayoum University Hospital
Introduction: To evaluate the preoperative risk factors for poor visual outcomes in unilateral pediatric cataract, mainly the interocular axial length difference (IALD).
Methods: Retrospective chart review of pediatric patients with unilateral congenital cataracts was done in a tertiary referral hospitals in Egypt ‘ABO EI Reesh Children Hospital, Cairo University’ and Fayoum university hospital. Subjects that had cataract extraction with primary IOL implantation were included and if the surgery was performed at the age from 10 months to 11 years. Statistical analysis was done.
Results: Thirty subjects were used in our study that had all inclusion criteria, with complete response. Mean IALD was 1.37 mm. The mean IALD was 0.26 mm only in patients with good visual outcome while those who had fair and poor outcome, it was 1.87 mm and 2.24 mm respectively. All the patients who had good visual outcome were compliant to amblyopia therapy while 60% of patients with fair visual outcome and 28.50% of those with poor visual outcome only showed compliance. Mean age at the time of surgery was 39.40 months. Eleven patients had good vision. 91.9% of them were younger than 2 years old at the time of surgery.
Discussion: It goes with the opinion of Fangqin Ma et al., Gochnauer et al., Chak et al., Lundvall & Kugelberg and Ondraaek & Lokaj but not with Ledoux et al.
Conclusion: The smaller preoperative IALD, the younger the surgical age, the better the compliance to amblyopia therapy, the better will be the visual outcome in child with unilateral cataract.
References: 1. Ledoux DM, Trivedi RH, Wilson ME Jr, Payne JF. Pediatric cataract extraction with intraocular lens implantation: visual acuity outcome when measured at age four years and older. J AAPOS 2007;11:218-24.
2. Gochnauer A, Trivedi R, Hill E, Wilson M. Interocular axial length difference as a predictor of postoperative visual acuity after unilateral pediatric cataract extraction with primary IOL implantation. JAAPOS 2010; 14:20-24.
3. Fangqin Ma, Meiyu Ren, Lihua Wang, Qi Wang, Jingli Guo. Visual outcomes of dense pediatric cataract surgery in eastern China. PLoS One. 2017; 12(7): e0180166.