Long-term Outcomes after Surgery for Congenital Unilateral Cataract

ABSTRACT

PURPOSE: To evaluate the long-term visual outcome after surgery for congenital unilateral cataract in children. METHODS: We retrospectively analyzed age, associated ocular disease, preoperative and postoperative visual acuity, type of cataract, operation method, and final visual outcome in 34 children, 12 years or younger, that had undergone congenital unilateral cataract surgery with a minimum follow-up period of one year. RESULTS: The mean age was 4.9 years and the mean follow-up duration was 26.5 months. Final visual acuity was less than 0.1 in 41.2%, better than 0.2 in 58.8%, better than 0.5 in 32.4%, and better than 0.8 in 20.6%. In the group whose preoperative visual acuity was less than 0.1, 27.2% of the eyes had a final visual acuity better than 0.5. This outcome is statistically significant compared with the 71.4% in the group whose preoperative visual acuity was better than 0.2 (p=0.02). In comparing the portion of patients whose final visual acuity was better than 0.5, only 8.3% were in the age group younger than 2 years at surgery; this is significantly lower than the 40.0% of patients in the age group between 3 to 6 years and the 50.0% of patients older than 7 years (p=0.03) whose final visual acuity was better than 0.5. CONCLUSIONS: Because long-term outcome of surgery for congenital unilateral cataract is not always satisfactory, it is necessary to determine the proper surgical time according to preoperative visual disturbance or severity of cataract, and to also do optical correction and aggressive treatment for amblyopia postoperatively.