title: Visual acuity and its predictors after surgery for bilateral cataracts in children.
abstract: PurposeThe objective of this study was to investigate preoperative factors associated with postoperative visual acuity outcomes and to develop a model to predict visual acuity prognosis.MethodsA retrospective study was conducted by reviewing clinical charts of pediatric patients who underwent bilateral cataract surgery by a single surgeon (MEW) at the Storm Eye Institute. A multiple logistic regression model was constructed to predict the odds of poor postoperative visual acuity, that is, worse than 20/40, based on age at surgery, gender, primary intraocular lens (IOL) placement, ethnicity, and preoperative nystagmus.ResultsA sample size of 157 children (314 eyes) was investigated with median duration of follow-up of 6.4 years. A total of 78% of children with bilateral cataract had postoperative visual acuity of 20/40 or better. The presence of preoperative nystagmus was highly correlated with poor postoperative visual acuity (OR=6.0; 95% CLs, 2.5-14.1; P-value<0.0001). Children of age <1 year at time of cataract extraction (OR=3.2; 95% CLs, 1.4-7.6; P-value=0.0073), male gender (OR=2.3; 95% CLs, 1.1-4.5; P-value=0.02), the absence of primary IOL placement (OR=3.0; 95% CLs, 1.05-8.4; P-value=0.04), and non-Caucasian ethnicity (OR=2.0; 95% CLs, 1.02-4.03; P-value 0.0447) were associated with poor visual acuity postoperatively.ConclusionsSatisfactory visual outcomes occurred in 78% of children operated on for bilateral cataracts. Preoperative nystagmus, age <1 year at time of cataract extraction, absence of primary IOL placement, male gender, and non-Caucasian ethnicity, were all factors associated with poor postoperative visual acuity.
authors.affiliation: Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA.|Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Bonaparte
authors.affiliation: Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Trivedi
authors.affiliation: Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: V
authors.initials: V
authors.lastname: Ramakrishnan
authors.affiliation: Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000550:Amblyopia / Q000150:complications; D002386:Cataract / Q000503:physiopathology*; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D019654:Lens Implantation, Intraocular; D008297:Male; D009759:Nystagmus, Pathologic / Q000150:complications; D011184:Postoperative Period; D011379:Prognosis; D019591:Pseudophakia / Q000503:physiopathology*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*