Intraoperative performance and postoperative outcomes of cataract surgery in infant eyes with microphthalmos.
OBJECTIVE
To report the intraoperative performance and postoperative outcomes in microphthalmic eyes of infants younger than 1 year having bilateral cataract surgery.


METHODS
Iladevi Cataract & IOL Research Centre, Ahmedabad, India.


METHODS
This prospective observational study excluded eyes with ocular trauma, inflammation, posterior persistent fetal vasculature causing stretching of the ciliary processes or tractional retinal detachment, aniridia, or chorioretinal coloboma. Intraoperative observations included the rate of peripheral extension of the anterior capsule tear, intraoperative iris prolapse/trauma, and posterior capsule tear. All eyes were left aphakic. Postoperative observations included visual outcome, posterior synechias, visual axis obscuration (VAO), and glaucoma.


RESULTS
The study evaluated 42 eyes of 21 infants. The mean age at surgery was 4.0 months +/- 2.6 (SD) and the mean follow-up, 25.6 +/-11.3 months. Surgery was performed using the limbal approach in 30 eyes (71.4%) and by pars plicata lensectomy in 12 eyes (28.6%). In the limbal group, 3 eyes (10.0%) had an incomplete anterior capsulorhexis, 2 eyes (6.7%) had iris trauma, and 2 eyes (6.7%) had peripheral extension of the posterior capsulectomy edge. At the final follow-up, visual acuity remained stable in 4 eyes (9.5%) and was improved in 38 eyes (90.5%). The complications were posterior synechias in 15 eyes (35.7%), glaucoma in 13 eyes (30.9%), and VAO in 7 eyes (16.7%).


CONCLUSIONS
The results suggest that good visual outcomes can be obtained in microphthalmic patients with bilateral congenital cataract after early surgical intervention, with an acceptable rate of serious postoperative complications.
Vasavada
Viraj A
VA
Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India.
Dixit
Nirmit V
NV
Ravat
Farida A
FA
Praveen
Mamidipudi R
MR
Shah
Sajani K
SK
Vasavada
Vaishali
V
Vasavada
Abhay R
AR
Trivedi
Rupal H
RH
D001036:Aphakia, Postcataract / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction / Q000379:methods*; D003261:Contact Lenses; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D008297:Male; D008850:Microphthalmos / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology