Short Term Visual and Refractive Outcome following Surgical Intervention for Posterior Capsule Opacification (PCO) in Children in a Tertiary Eye Hospital.

BACKGROUND: PCO occurs commonly postoperatively following cataract extraction in children, obscuring vision as did the initial cataract. It may require a second surgical procedure when it is dense. It is expected that this results in restoration of vision and it is important to ascertain that this is the case as well as to examine any significant changes in refraction thereafter. METHODS: A retrospective observational study extracting demographic and clinical information from case notes of patients who had membranectomy and/or capsule polishing between October 2017 and September 2018. RESULTS: 57 eyes of 51 patients were enrolled. There was a 2:1 male: female ratio. Mean age at cataract surgery was 6.33± 3.59years whilst that for PCO surgery was 9.68±3.89years. Postoperative visual acuity (by WHO definition) was good (between 6/6 and 6/18) in 33.3%, compared to 8.8% preoperatively. Whereas presenting visual acuity was poor (<6/60) in 61.4% preoperatively, this reduced to 30% postoperatively. Visual outcome was influenced by age at cataract surgery, age at PCO surgery, interval between cataract and PCO surgery and type of cataract. Children >8 years of age at time of PCO surgery had a greater proportion of good post-operative best corrected visual acuity (BCVA) (52.6%), whilst 75% of children younger than 8years at time of surgery turned out with poor BCVA after surgery. Developmental cataracts proportionately had the best outcome of visual acuity. There was a range of refractive shift of +0.25D to - 5.25D with a mean myopic shift of -1.51D following membranectomy. CONCLUSION: There was a good proportion of children with significant improvement in visual acuity on the short term, and a mild myopic shift following membranectomy.

CONTEXTE: Résultats visuels et réfractifs à court terme à la suite d'une intervention chirurgicale pour l'opacité de l'axe visuel (PCO) chez des enfants dans un hôpital ophtalmologique tertiaire. METHODES: Une étude d'observation rétrospective extrayant des informations démographiques de cas de patients ayant subi une membranectomie et / ou un polissage de gélule entre octobre 2017 et septembre 2018. RESULTATS: 57 yeux de 51 patients ont été inclus. Il y avait un ratio hommes / femmes de 2: 1. L'âge moyen à la chirurgie de la cataracte était de 5,9 ans alors que celui de la chirurgie du VAO était de 9,2 ans. L'acuité visuelle postopératoire était bonne (entre 6/6 et 6/18) dans 33,3% des cas, contre 8,8% en préopératoire. Alors que l'acuité visuelle était faible (<6/60) dans 61,4% des cas en préopératoire, elle était réduite à 30% en postopératoire. Les enfants de plus de 8 ans au moment de la chirurgie PCO présentaient une plus grande proportion de BCVA postopératoires satisfaisants (52,6%), tandis que 75% des enfants de moins de 8 ans au moment de la chirurgie avaient un BCVA médiocre après la chirurgie PCO. Les résultats visuels étaient influencés par l'âge au moment de la chirurgie de la cataracte et de la PCO, l'intervalle entre les chirurgies de la cataracte et de la PCO et le type de cataracte. Il y avait une plage de décalage de réfraction de +0,25 à -5,25 avec un décalage myopique moyen de 1,51D après la membranectomie. La cataracte développementale avait proportionnellement le meilleur résultat en acuité visuelle. CONCLUSION: Il y avait une bonne proportion d'enfants présentant une amélioration significative de l'acuité visuelle à court terme malgré un léger déplacement de la myopie après une membranectomie. Mots-clés: opacification de l'axe visuel, cataracte, changement myope, résultat visuel.

Short Term Visual and Refractive Outcome following Surgical Intervention forPosterior Capsule Opacification (PCO) in Children in a Tertiary Eye Hospital

BACKGROUND: PCO occurs commonly postoperatively followingcataract extraction in children, obscuring vision as did the initialcataract. It may require a second surgical procedure when it is dense.It is expected that this results in restoration of vision and it is importantto ascertain that this is the case as well as to examine any significantchanges in refraction thereafter.M ETHODS: A retrospective observational study extractingdemographic and clinical information from case notes of patients whohad membranectomy and/or capsule polishing between October 2017and September 2018.RESULTS: 57 eyes of 51 patients were enrolled. There was a 2:1male: female ratio. Mean age at cataract surgery was 6.33 3.59yearswhilst that for PCO surgery was 9.68 3.89years. Postoperativevisual acuity (by WHO definition) was good (between 6/6 and 6/18)in 33.3%, compared to 8.8% preoperatively. Whereas presenting visualacuity was poor (<6/60) in 61.4% preoperatively, this reduced to30% postoperatively. Visual outcome was influenced by age at cataractsurgery, age at PCO surgery, interval between cataract and PCO surgeryand type of cataract. Children >8 years of age at time of PCO surgeryhad a greater proportion of good post-operative best corrected visualacuity (BCVA) (52.6%), whilst 75% of children younger than 8yearsat time of surgery turned out with poor BCVA after surgery.Developmental cataracts proportionately had the best outcome ofvisual acuity. There was a range of refractive shift of +0.25D to ­5.25D with a mean myopic shift of ­1.51D following membranectomy. CONCLUSION: There was a good proportion of children withsignificant improvement in visual acuity on the short term,and a mildmyopic shift following membranectomy.