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Abstract #10512 Published in IGR 6-1
Complications in infants undergoing surgery for congenital cataract in the first 12 weeks of life: is early surgery better?
Watts P; Abdolell M; Levin AVJournal of AAPOS 2003; 7: 81-85
PURPOSE: To determine whether there is an association between the timing of surgical intervention for congenital cataract within the first 12 weeks of life and the prevalence of postoperative complications. METHODS: The authors performed a retrospective review of records from 1990-2000 of infants who underwent surgery for congenital cataract within the first 12 weeks of life. Eighty eyes of 55 children were involved with a minimum follow-up of six months. Bilateral cataracts were present in 25 and monocular cataracts in 30 infants. A limbal approach lensectomy-vitrectomy was performed in all infants. Children with aphakia were rehabilitated with contact lens or glasses. Operative and postoperative complications - including glaucoma, nystagmus, strabismus, retinal detachment, and posterior capsule opacification/secondary membranes - were recorded. Ocular and systemic associations were noted. Statistical analysis was carried out with classification and regression trees (CART). RESULTS: The mean age at the time of surgery was 31.5 ± 23.3 days (median, 26.5; range, 2-84). Mean follow-up from the time of surgery was 2.85 ± 1.9 years (median, 2; range, 0.5-8). Persistent fetal vasculature (persistent hyperplastic primary vitreous) was present in 14 eyes. One infant with bilateral persistent fetal vasculature had bilateral retinal dysplasia and was excluded from the analysis. Glaucoma developed in 12 infants (22%); nystagmus was present in 18 infants (33%); strabismus developed in 28 infants (52%); and secondary membranes developed in seven eyes (13%). CART analysis suggests that glaucoma is more prevalent in infants when the surgery was performed between 13.5 and 43 days of life (CART = 0.370); nystagmus when surgery is performed between 48 and 84 days of life (CART = 0.500); strabismus when surgery is performed between 55.5 and 84 days of life (CART = 0.600); and secondary membranes when surgery is performed between 26.5 and 40 days of life (CART = 0.4). CONCLUSIONS: These data suggest that the first two weeks of life comprise the most favorable time for decreasing postoperative complications resulting from surgical intervention for infants presenting with cataracts within the first 12 weeks of life.
Dr. A.V. Levin, Department of Ophthalmology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
Classification:
9.4.4.2 Glaucomas associated with cataracts (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
