Artikel
Complications in infants undergoing surgery for congenital cataract in the first 18 months of life
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
Surgery for congenital cataracts in infancy usually includes primary posterior capsulotomy and anterior vitrectomy. Most of these children have aphakia after surgery. The purpose of this study was to determine the incidence of postoperative complications in children treated for congenital cataract with aphakia.
Methods
We performed a retrospective review of records from 1996 to 2002 of infants who underwent surgery for congenital cataract within the first 18 months of life. 48 eyes of 32 children were involved with a mean follow-up of 35 months. Bilateral cataracts were present in 17 children (33 eyes operated) and monolateral cataracts in 15 children. A limbal approach phacoemulsification and anterior vitrectomy without intraocular lens implantation was performed in all children. Operative and postoperative complications - including hemorrhages, glaucoma, retinal detachment, and posterior capsule opacification - were recorded. Statistical analysis of differences between corresponding groups was performed by Chi2-test.
Results
Bilateral aphakic glaucoma developed in 5 eyes (10.4 %) and posterior capsule opacification developed in 3 eyes (6.25 %). The diagnosis of postoperativ hemorrhages was recorded in 8 eyes and 2 eyes developed retinal detachment Persistent fetal vasculature or persistent hyperplastic primary vitreous (PHPV) was present in 12 eyes (25 %). The diagnosis of postoperative hemorrhages was significantly associated with the presence of PHPV (P < 0.0001).
Conclusions
Our results indicate that postoperative hemorrhages are highly prevalent in pediatric cataract eyes with persistent hyperplastic primary vitreous. Therefore, ultrasonography should be part of the routine work-up prior to surgery in these patients.