VISUAL OUTCOME AND CHANGE IN REFRACTION AFTER PAEDIATRIC CATARACT SURGERY

Abstract

Swapna Kaipu1, Kiran Kumar Gudala2, Chandrasekhar G3, Rama Mohan Pathapati4, Madhavulu Buchineni5, Sailaja Manikala6

INTRODUCTION: Cataract remains one of the most important avoidable causes of blindness in children. IOL implantation has the advantage of immediate visual rehabilitation, less hospital visits and less vigorous supervision by the ophthalmologists. We assessed the effects of intra ocular lens implantation on post-operative complications, method of optical correction, and presence of amblyopia as immediate visual outcomes. Additionally, changes in refraction in one year follow up period.

METHODS: We studied congenital and developmental cataract who underwent extra capsular cataract extraction (ECCE) with posterior capsulotomy and anterior vitrectomy between 2007 and 2010. Patient demographics, cataract type, presenting symptom, complications of surgery, post-operative visual acuity and refractive changes were recorded.

RESULTS: 34 children were included and a total 50 eyes of were evaluated. Unilateral cataracts were present in 18(51.43%) patients, and are predominantly in age group of 9-14 years. Post operatively 13 patients had visual acuiy<6/60, compared to 47 patients at admission. The most common early post-operative complication observed was fibrinous uveitis which occurred in 6 patients. At the end of 1 year follow up 28 eyes showed increase in axial length of that 13 patients are in age group of 1-4 years.

CONCLUSION: Primary IOL implantation and primary posterior capsulorrhexis with anterior vitrectomy is a safe and effective method for pediatric cataract, We observed less post-operative complications, improved visual acuity, and less refractive changes. Intraocular lens implantation acts as an aid for early visual rehabilitation for pediatric cataracts if the children undergo surgery before abnormal foveolar function develops.

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