Korean J Ophthalmol.  2018 Aug;32(4):273-280. 10.3341/kjo.2017.0113.

Predicting Factor of Visual Outcome in Unilateral Idiopathic Cataract Surgery in Patients Aged 3 to 10 Years

• Park J
• Lee YG
• Kim KY
• Kim BY

• KMID: 2418147
• DOI: http://doi.org/10.3341/kjo.2017.0113

Abstract

PURPOSE
To report the surgical results of unilateral pediatric cataracts from uncertain causes in relatively older children and to identify factors related to better visual outcomes.
METHODS
We retrospectively evaluated the medical records of 39 patients who underwent surgery between the ages of 3 and 10 years for unilateral pediatric cataracts of no known cause. All patients underwent primary intraocular lens implantation and postoperative amblyopia treatment. A postoperative final visual acuity better than 20 / 30 was considered to be a good visual outcome.
RESULTS
The mean age of patients was 6.0 ± 1.8 years at the time of surgery. The mean preoperative visual acuity was 1.07 ± 0.71 logarithm of the minimum angle of resolution (range, 0.15 to 3.00), while the mean final postoperative visual acuity was 0.47 ± 0.54 logarithm of the minimum angle of resolution (range, 0.00 to 2.00). Of 39 patients, 18 (46.2%) achieved a good visual outcome. Only the preoperative visual acuity maintained a significant association with a good visual outcome according to our multivariate analysis (p = 0.040). A preoperative visual acuity of 20 / 100 or better was found to increase the chance of achieving a good visual outcome by 13.79-fold (95% confidence interval, 1.13 to 167.58).
CONCLUSIONS
The visual outcome of unilateral pediatric cataract surgery for cataracts with no specific cause identified in patients after three years of age could be satisfactory, especially with a preoperative visual acuity of 20 / 100 or better.

Keyword

Congenital cataract; Phacoemulsification; Prognosis; Visual acuity

MeSH Terms

Amblyopia
Cataract*
Child
Humans
Lens Implantation, Intraocular
Medical Records
Multivariate Analysis
Phacoemulsification
Prognosis
Retrospective Studies
Visual Acuity

Figure

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  Fig. 1 Flow chart of the inclusion/exclusion criteria and complication case. VA = visual acuity.

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  Fig. 2 Changes in visual acuity in all eyes. The mean final postoperative visual acuity was 0.34 ± 0.29 (0.47 ± 0.54 logarithm of the minimum angle of resolution) in the operated eye. Visual acuity was mostly improved during the first postoperative month. Error bars indicate standard deviation.

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  Fig. 3 Changes in refractive error. The mean refractive error was 0.12 ± 2.51 diopters (D) one year postoperatively, and the mean final refractive error was −1.48 ± 2.97 D in the operated eye. The mean rate of refractive change per year was −0.65 D. Error bars indicate standard deviation.

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  Fig. 4 A comparison of changes in visual acuity (VA) according to the preoperative VA. Patients with a preoperative VA of 20 / 100 or better had an increased chance of achieving a good visual outcome compared to those with a preoperative VA less than 20 / 100. Error bars indicate standard deviation.

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