OUTCOME OF CATARACT SURGERY IN PATIENTS LESS THAN THREE YEARS OF AGE

• Vijaya H Pai,  
• Divya Trivedi,  
• Sushan Shankar Shetty*

Abstract

Cataract surgery in pediatric patients presents unique challenges owing to anatomical and physiological differences from adult eyes. This study investigates the outcomes of cataract surgery in children under three years old, focusing on surgical techniques, complications, and post-operative visual improvements. Conducted from September 2017 to August 2019 at Kasturba Hospital, Manipal, this prospective observational study enrolled children under three years undergoing cataract surgery. Patients with a minimum six-month follow-up post-surgery were included. Surgical procedures, patient demographics, and outcomes were recorded and analyzed using descriptive statistics. Of the 60 eyes from 37 patients included, 62.16% had bilateral cataracts, with congenital cataracts being the most prevalent (56.75%). Lens aspiration with posterior primary capsulotomy, anterior vitrectomy, and peripheral iridectomy were common surgical techniques, with 61.66% receiving intraocular lens (IOL) implantation. Optical rehabilitation varied, with 61.66% receiving IOLs, 33.34% aphakic glasses, and 5% contact lenses. Post-operatively, 50% showed improved visual acuity, while complications occurred in 33.33% of eyes, most commonly posterior capsular opacification (16.67%). Notably, glaucoma was rare (1.67%). However, the study lacked statistical power due to the small sample size and variability in surgical techniques among the four operating surgeons. Comparison with existing literature revealed trends in complication rates and visual outcomes, with posterior capsular opacification being a predominant post-operative complication. However, the study's limitations, including sample size and surgical variations, underscore the need for larger, standardized studies to draw more definitive conclusions. In conclusion, lens aspiration with primary posterior capsulotomy and anterior vitrectomy, with or without IOL implantation, appears to be a safe and effective procedure for pediatric cataracts, with notable post-operative visual improvements. Further research with larger cohorts and standardized procedures is warranted to elucidate factors influencing outcomes and optimize surgical techniques in this vulnerable patient population.

Keywords

pediatric cataract ,primary posterior capsulotomy,anterior vitectomy,less than three years