Risk Factors for Complications After Congenital Cataract Surgery

Risk Factors for Complications After Congenital Cataract Surgery
July’s AJO

Kuhli-Hattenbach et al. investigated individual risk factors for the development of complications in children undergoing pediatric cataract surgery.The authors reviewed the records of 67 eyes of 44 children who underwent congenital cataract surgery in the first 18 months of life. They performed a limbal-approach bimanual lens aspiration, a posterior capsulorhexis and an anterior vitrectomy without IOL implantation for all children. The mean follow-up period was 39 months.The most frequent postoperative complications were late-onset open-angle glaucoma (11 percent) and vitreous hemorrhage (11 percent), whereas early-onset glaucoma (5 percent) was less common. Secondary cataract was observed in seven eyes (9 percent). A family history of aphakic glaucoma in first-degree relatives, cataract surgery in the first three months of life and nuclear cataracts were strong predictors of late-onset glaucoma. Secondary cataract formation was associated strongly with lensectomy in the first five months of life. The diagnosis of postoperative hemorrhages was associated significantly with the presence of persistent fetal vasculature.

The authors conclude that potential risk factors for complications after congenital cataract surgery include young age at the time of surgery, a family history of aphakic glaucoma, nuclear cataract or persistent fetal vasculature syndrome. They also note that it is not clear how the results might differ if an IOL had been implanted at the time of surgery.