Corneal edema after pediatric cataract surgery.
BACKGROUND
We have encountered idiopathic corneal edema in four patients (five eyes) after pediatric lensectomy. This problem has not been previously described in the pediatric ophthalmology literature.


METHODS
Clinical and operative records were reviewed. The children, who ranged in age from 15 months to 6 years, underwent apparently uncomplicated limbal lensectomy without lens implantation. After surgery, all received subconjunctival hydrocortisone (12.5 mg) and 2 to 4 drops daily of topical prednisolone acetate. The corneal edema developed between 2 and 14 days after surgery.


RESULTS
The condition cleared in all patients during a 5- to 14-day course of intensive topical steroids. No sequelae have been apparent. Final visual acuities are 20/30 or better in the three children (four eyes) old enough for recognition acuity testing. The fifth eye has excellent central fixation.


CONCLUSIONS
We suspect that the corneal decompensation was a manifestation of sterile inflammation. Two of the children had a history of iritis. Difficulty measuring cellular response at the slit-lamp examination and instilling eyedrops at home may have contributed to the complication. Postoperative corneal decompensation can be responsive to topical steroids, which we now prescribe more intensively even in apparently quiet eyes.
Simon
J W
JW
Albany Medical Center's Lions Eye Institute, New York 12208, USA.
Miter
D
D
Zobal-Ratner
J
J
Hodgetts
D
D
Belin
M W
MW
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002387:Cataract Extraction / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015715:Corneal Edema / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections; D008297:Male; D013256:Steroids; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D013256:Steroids