Complications of pediatric cataract surgery and intraocular lens implantation.
OBJECTIVE
To study the pattern of postoperative complications following extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation in pediatric eyes.


METHODS
Tertiary eye care center, New Delhi, India.


METHODS
A retrospective analysis of 39 eyes of 28 children referred for complications after ECCE with IOL implantation was performed. The results evaluated were visual acuity, iridocapsular problems, and IOL-related complications. Additional interventions such as neodymium:YAG (Nd:YAG) capsulotomy, surgical membranectomy, and penetrating keratoplasty (PKP) were done when necessary. Visual acuity was measured 1 week following intervention and at the last follow-up.


RESULTS
Congenital (17 eyes, 43.6%), developmental (11 eyes, 28.2%), and traumatic (11 eyes, 28.2%) cataract were the indications for surgery. Posterior capsule opacification (34 eyes, 87.2%), updrawn pupil (15 eyes, 38.5%), decentered IOL (13 eyes, 33.3%), and pupillary capture (12 eyes, 30.8%) were the major complications. An Nd:YAG capsulotomy was attempted in 19 eyes (48.7%). Surgical membranectomy was performed in 10 eyes (25.6%); PKP was performed in 2 eyes (5.1%) to treat pseudophakic bullous keratopathy. One eye had to be eviscerated because of uncontrolled endophthalmitis. In 31 eyes in which visual acuity could be measured, 27 had an acuity of 6/60 or worse at the time of presentation. Following intervention and amblyopia therapy, 19 eyes achieved a visual acuity of 6/18 or better.


CONCLUSIONS
Routine ECCE with IOL implantation in pediatric eyes is associated with various problems and may lead to permanent visual disability.
Sharma
N
N
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Pushker
N
N
Dada
T
T
Vajpayee
R B
RB
Dada
V K
VK
D019923:Capsulorhexis / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D054018:Lasers, Excimer; D007903:Lens Capsule, Crystalline / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy