Challenges and Complications in the Management of Systemic Diseases in Congenital Cataract Surgery

Abstract

Purpose: To examine the effects of accompanying systemic diseases on surgery preparation and follow-up in congenital and infantile cataract cases.

Methods: The files of patients aged 0 to 12 months presenting to one clinic between January 2010 and January 2024 and scheduled for cataract surgery were retrospectively scanned. The patients' demographic data, gestational age, age at admission and surgery, accompanying systemic diseases, and systemic complications that developed before, during, and after surgery were recorded.

Results: A total of 142 patients (75 girls, 67 boys) were included in the study. The average follow-up period was 30.6 ± 33.9 months (range: 2 to 159 months). Unilateral cataract surgery was performed in 45 (31.7%) patients and bilateral cataract surgery was performed in 97 (68.3%) patients. The average number of gestational age was 37.2 ± 3.4 week (range: 23 to 41 weeks). The average age at presentation was 4.22 ± 3.20 months (range: 1 to 12 months). Systemic pathology was present before surgery in 40 patients (28.2%). Neuromuscular system diseases were the most common accompanying systemic pathology (15 patients), followed by genetic diseases (13 patients). Eleven (7.7%) patients had facial anomalies, and 21 (14.8%) were at risk of malignant hyperthermia during anesthesia. Eighteen (12.7%) were defined as having difficult intubation, and 46 patients (32.4%) required postoperative pediatric intensive care. One patient died due to pneumonia during surgery preparations, and 4 patients died due to systemic complications unrelated to the surgery during the follow-up period.

Conclusions: Congenital cataract cases require a multi-disciplinary approach to surgical planning that considers systemic comorbidities, anesthesia management, and postoperative follow-up.