Preoperative factors affecting visual outcome after unilateral cataract extraction in pediatric age group

Purpose
The aim was to analyze preoperative factors that result in a poor postoperative (PO)
visual outcome in cases with unilateral cataract, mainly the relationship between
preoperative interocular axial length difference (IALD) and PO visual acuity.
Materials and methods
A retrospective chart review of 200 pediatric patients with unilateral congenital
cataracts was carried out from 2011 to 2015. A total of 30 participants who had
cataract extraction with primary intraocular lens implantation were included, with
the performed surgical procedure at an age between 10 months and 11 years older
at the time of surgery. Statistical analysis was done.
Results
A total of 30 participants were included in this study who fulfilled all the inclusion
criteria and provided complete responses. Mean IALD was 1.37 mm. The mean
IALD was 0.26mm solely in patients with good visual outcome, whereas children
who had a fair and poor outcome, the mean IALD was 1.87 and 2.24 mm,
respectively (P=0.008). All the patients who had good visual outcome were
compliant with amblyopia therapy, whereas 60% of patients with the fair visual
outcome and 28.50% of those with poor visual outcome solely were compliant with
amblyopia therapy (P=0.001). Mean age at the time of surgery was 39.40 months.
Eleven patients had good vision, and 91.9% of them were younger than 2 years old
at the time of surgery (P=0.001).
Conclusion
The smaller the preoperative IALD, the younger the surgical age, the earlier the
surgical intervention, and the higher the compliance with amblyopia therapy, the
higher is the PO visual acuity in a child with unilateral cataract.