gms | German Medical Science

104th DOG Annual Meeting

21. - 24.09.2006, Berlin

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Long-term results after surgery of congenital cataract with hyperplastic primary vitreous in the infants: 16-year experiences

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  • I. Helmanová - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • R. Autrata - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • S. Pyrochtová - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • J. Řehůřek - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogP225

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2006/06dog747.shtml

Published: September 18, 2006

© 2006 Helmanová et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

This retrospective study evaluated the visual outcome of children with dense cataract and unilateral PHPV after surgery performed during the first six months of their life. We evaluated the outcome of cataract-PHPV eyes left aphakic with correction of contact lenses (CL) and compared it with those undergoing intraocular lens (IOL) implantation at the time of surgery.

Methods

A total of 59 consecutive children (31 girls, 28 boys) with unilateral PHPV and cataract, treated and followed at our clinic between 1988-2002, were included in this retrospective study. The mean age at the time of surgery was 4.39 months (range: 2 to 6 months). The mean follow-up time was 7.3 years (range: 4 to 16 years). Cataract extraction combined with vitrectomy and removal of embryonic remnants was performed in 27 eyes (46.9%) remained aphakic. IOLs were primary implanted in 32 eyes (53.1%) In 5 eyes an ACIOL and in 22 eyes a PCIOL (sulcus or in-the-bag) was implanted. All children had patching of the dominant eye up to 70% of the waking time.The best corrected visual acuity, rate of complications, need for additional surgical procedures were evaluated. Statistical analysis by Student t test (2-tailed) was used and significance was taken at the 0.05 level or lower.

Results

BCVA of 6/15 or better was obtained in 32.6% (18 of 59 eyes), 40.7% (24 of 59) reached 6/21-6/60 BCVA, and 28.8% (17 of 59) had a visual acuity of 3/60 to perception of light in the entire group. None of the eyes were totally blind. A higher rate of good visual acuity (6/15 or better) in children with pseudophakia (11 of 18 eyes, 68.7%) was not found statistically different from the rate in children with aphakia (5 of 18 eyes, 31.3%) (P=0.093). A poor visual outcome (3/60 to perception of light) had 12 of 14 aphakic eyes (85.7%) and 2 of 14 pseudophakic eyes (14.3%) (P=0.026). Secondary glaucoma was observed in 8 of 24 (34.8%) patients with aphakia, 4 of 27(15.4%) patients with pseudophakia (P=0.315). The most common additional surgery performed in both groups was strabismus surgery.

Conclusions

Based on our results we suggest that PHPV eyes have a potential for favorable visual rehabilitation after surgery performed during the first six months after birth. Intraocular lens implantation may be a safe and useful option for the management of these children.