Results of a prospective evaluation of three methods of management of pediatric cataracts

S. Basti, U. Ravishankar, S. Gupta*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

99 Scopus citations

Abstract

Background: Although a variety of approaches to manage cataracts in children have been studied, no consensus exists on the optimum approach. The authors, therefore, conducted a prospective, nonrandomized, consecutive study to evaluate three most commonly adopted methods of management of pediatric cataracts. Methods: Lensectomy anterior vitrectomy (LAV), extracapsular cataract extraction with intraocular lens implantation (ECCE + IOL) and ECCE, primary posterior capsulotomy, anterior vitrectomy with IOL (ECCE + PPC + AV + IOL) were the surgical procedures performed. Aphakia in the LAV group was corrected with spectacles or contact lenses. Intraoperative and postoperative results were analyzed. Discrete variables among the three groups were compared using chi square test. Results: One hundred ninety-two eyes were included in the study. There was no statistically significant difference in the intraoperative complications in the three groups. During a mean follow- up period of 11.3 months, postoperative obscuration of the visual axis was seen in 43.7% of eyes in the ECCE + IOL group and in 3.65% of eyes in the ECCE + PC + AV + IOL (P < 0.001). Two of the seven patients in the LAV group in whom contact lenses were prescribed developed corneal infiltrates. Severe postoperative anterior uveitis occurred in 15.9% and 13.8% of eyes in the ECCE + PPC + AV + IOL and ECCE + IOL groups, respectively. None of the eyes that underwent LAV developed this complication (P < 0.001). There was no statistically significant difference in the incidence of retinal detachment, endophthalmitis, or glaucoma in the three groups. Conclusion: Of the three approaches, ECCE + PPC + AV + IOL was conducive to at least short-term maintenance of a clear visual axis, provided optimum refractive correction, and was not associated with increased risk of short-term complications. Continued follow-up of these eyes is necessary to conclude on the long-term results of this technique.

Original languageEnglish (US)
Pages (from-to)713-720
Number of pages8
JournalOphthalmology
Volume103
Issue number5
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Ophthalmology

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