Clinical characteristics of congenital cataract in 476 children / 眼科新进展

ABSTRACT

Objective To analyze the operative methods,intraocular lens (IOL) implantation and postoperative complications in children with congenital cataract,and give the references for treating of congenital cataract.Methods From January 2008 to January 2016,children under the age of 13 years with congenital cataract were enrolled.Preoperative and posterior slit lamp microscope,fundus,intraocular pressure were examined.Children under 2 years old were treated with phacoemulsification (PHACO),posterior continuous curvilinear capsulorrhexis (PCCC),anterior-vitrectomy (AV),and ＞ 2-4 years old with PHACO + PCCC + AV + IOL implantation,＞ 4-7 years old children with PHACO + PCCC + IOL implantation,children ＞ 7 years with PHACO + IOL implantation.Results A total of 476 patients (740 eyes) were enrolled in the study,the average age were (33.59 ± 37.14) months,of which 0 ～ 6 months were 166 cases (282 eyes,38.11％).260 eyes were implanted with IOL,aged (5.59 ±2.43) years,480eyes were implanted in the second surgery,aged (4.06 ± 2.12) years.Refaction diopter (equivalent spherical) after IOL implantation in children aged ＞ 2-4 years old was (3.53 ± 0.56) D,＞ 4-6 years old was (2.36 ± 0.32) D,＞ 6-8 years old was (1.65 ±0.52)D,＞8-13 years old was (-0.25 ±0.32) D.The postoperative complications occurred in 326 eyes,of which 115 eyes (35.28％) with iridotic adhesions,97 eyes (29.75％) with posterior cataract on the visual axis,and 54 eyes (16.56％) with glaucoma.At the last follow-up,the best corrected visual acuity were (0.56 ± 0.41) LogMAR for monocular cataract surgery and (0.42 ± 0.27) LogMAR for binocular cataract surgery,the difference was statistically significant (P =0.04).Conclusion One-third of children with congenital cataract are treated with surgical treatment under 6 months old,about half of the children undergo IOL implantation at 2 ～ 3 years of age.The postoperative visual acuity in children with binocular cataract is better than children with monocular cataract.The complications in children are more complicated than adults,which should be paid more attention.