Visual outcome after paediatric cataract surgery: is age a major factor?

Abstract

Aims: To determine functional results after unilateral and bilateral cataract surgery in children with different aphakic optical correction.

Methods: In this retrospective study, we evaluated visual acuity and binocular vision in 107 children who underwent cataract surgery during the 10 year period from 1985 to 1995. Aphakia was corrected by an intracapsular intraocular lens (IOL), spectacles or contact lenses.

Results: Mean visual acuity was > 20/40 (< 0.3 log MAR) with normal binocular vision in 58 children over 7 months of age operated on for bilateral cataracts. Pseudophakic eyes regained visual acuity > 20/63 (< 0.5 log MAR) more often (90%) than aphakic eyes (46%) (p < 0.001). Binocular vision was also achieved more often after IOL implantation (p < 0.001). Visual outcome of early bilateral cataracts was less satisfactory in children with abnormal foveolar function. For 49 children who had surgery for unilateral cataracts, prognosis was poor when surgery was performed before the age of 7 months. For cataract surgery in older children (> or = 7 months) mean visual acuities were better with IOL implantation (p < 0.05).

Conclusion: Cataract surgery with unilateral and bilateral IOL implantation can provide a beneficial effect on final visual outcome in children who are operated on before abnormal foveolar function develops.

Figure 1

Unilateral cataracts. Distribution of visual acuities in pseudophakic (IOL) and aphakic (No IOL) eyes after surgery for early (group U1), late (group U2), and traumatic (group U3) cataracts.

Figure 2

Bilateral cataracts. Distribution of visual acuities in pseudophakic (IOL) and aphakic (No IOL) eyes after surgery for early (group B1) and late (group B2) cataracts.

Figure 3

Binocular vision; difference in patients with (IOL) and without (No IOL) lens implantation.