Predicting future axial length in patients with paediatric cataract and primary intraocular lens implantation

2020 ◽  
pp. 112067212094874
Author(s):  
Antonio Carlos Lottelli
Keyword(s):  
Axial Length ◽  
Influence Factors ◽  
Male And Female ◽  
Iol Implantation ◽  
Bilateral Cataract ◽  
Age At Surgery ◽  
Lens Implantation ◽  
Unilateral Cataract ◽  
Paediatric Cataract

Objective: Creating a model to predict Axial Length (AL) growth in paediatric cataract and evaluating influence factors. Material and methods: Eyes with AL measured at surgery and at least one measurement after a 6-month period, from children with unilateral or bilateral cataract and primary IOL implantation, were evaluated. A “rate of axial length growth” (RALG) was calculated for every single eye using these AL measurements and log10 age. One average RALG was calculated for All Eyes and for the groups of Bilateral and Unilateral, Gender, Age at the Surgery, different Visual Acuity, Bilateral Excluded and Not-excluded eye, and Affected and Not-affected eye in unilateral, for comparisons. Results: Average age at surgery from 76 children was 2.83 ± 2.74 (0.11–12.21) years with follow up of 2.84 ± 1.84 (0.52–8.17) years, 29 (37.66%) had unilateral cataract. A total of 357 AL measurements were used, average of 4.70 ± 2.13 (2–10) measurements per eye. The average RALG for all eyes was 4.51 ± 3.06. There were no RALG significant differences comparing Unilateral and Bilateral eyes ( p = 0.51), Male and Female ( p = 0.26), Age at Surgery <0.5 and >0.5 years old ( p = 0.21), both eyes in Bilateral cases ( p = 0.70) and Unilateral Affected and Not-affected eyes ( p = 0.18). The equation Al = initial AL + slope ×  Log10 ((age + 0.6)⁄(initial age + 0.6)) estimates ALs in different ages. Conclusions: A model to predict AL growth in paediatric cataract was developed. Different studied factors did not significantly influence AL growth.

scholarly journals Glaucoma following cataract surgery in the first 2 years of life: frequency, risk factors and outcomes from IoLunder2

2019 ◽  
Vol 104 (7) ◽  
pp. 967-973 ◽  
Author(s):  
Ameenat Lola Solebo ◽  
Jugnoo S Rahi
Keyword(s):  
Adverse Events ◽  
Cataract Surgery ◽  
Axial Length ◽  
Multivariable Analysis ◽  
Population Based ◽  
Secondary Glaucoma ◽  
Bilateral Cataract ◽  
Younger Age ◽  
Age At Surgery ◽  
Unilateral Disease

BackgroundWe investigated glaucoma related adverse events, predictors and impact at 5 years following surgery in the IoLunder2 cohortMethodsPopulation based observational cohort study of children undergoing cataract surgery aged 2 years or under between January 2009 and December 2010. Glaucoma was defined using internationally accepted taxonomies based on the consequences of elevated intraocular pressure (IOP). Glaucoma related adverse events were any involving elevated IOP. Multivariable analysis was undertaken to investigate potential predictors of secondary glaucoma with adjustment for within-child correlation in bilateral cataract. Unilateral and bilateral cataract were analysed separately.ResultsComplete follow-up data were available for 235 of 254, 93% of the inception cohort. By 5 years after primary cataract surgery, 20% of children with bilateral cataract and 12% with unilateral had developed secondary glaucoma. Glaucoma related complications had been diagnosed in 24% and 36% of children, respectively. Independent predictors of glaucoma were younger age at surgery (adjusted OR for reduction of week in age: 1.1, 95%C I 1.1 to 1.2, p<0.001); the presence of significant ocular comorbidity (adj OR 3.2, 95% CI 1.1 to 9.6, p=0.01); and shorter axial length (adj OR for each mm 1.7, 95% CI 10.0 to 1, p=0.05) for bilateral cataract. Shorter axial length was the single independent factor in unilateral disease (adj OR 9.6, 95% CI 1.7 to 52, p=0.009)ConclusionsBoth younger age at surgery (the strongest marker of ocular ‘immaturity’) and smaller ocular size (a marker of both immaturity and developmental vulnerability) can be used to identify those at greatest risk of glaucoma due to early life cataract surgery.

Follow-up patterns and associated risk factors after paediatric cataract surgery: observation over a 5-year period

2018 ◽  
Vol 102 (11) ◽  
pp. 1550-1555 ◽  
Author(s):  
Pratik Chougule ◽  
Shamsiya Murat ◽  
Ashik Mohamed ◽  
Ramesh Kekunnaya
Keyword(s):  
Cataract Surgery ◽  
Economic Status ◽  
Socioeconomic Group ◽  
Female Ratio ◽  
Logarithmic Curve ◽  
Age At Surgery ◽  
Developmental Cataract ◽  
Associated Risk Factors ◽  
Paediatric Cataract

PurposeTo study the pattern of compliance to follow-up of children less than 5 years of age undergoing surgery for congenital and developmental cataract over a period of 5 years.MethodsIt is a retrospective study of children less than 5 years of age undergoing cataract surgery between January and December 2010 for congenital or developmental cataract and followed up until 31 December 2015. Age, sex, distance from hospital and urban or rural habitat, delay in presentation, socioeconomic status, laterality, morphology and type of cataract, implantation of intraocular lens and interventions done were noted. Compliance to follow-up at postoperative 1 week, 1 month, 3 months, 6 months, 1 year and then once a year until 5 years were recorded.Results169 patients were included in the study. The median follow-up was 22 months. Median age at surgery was 10 months and had a negative correlation with total follow-up. Male-to-female ratio was 1.82. Logarithmic curve of follow-up was noticed with 85%, 61%, 55%, 52%, 39% and 28% patients attending 1 month, 3 months, 6 months, 1 year, 3 years and 5 years of follow-up, respectively. Low socioeconomic group had poor follow-up compared with higher socioeconomic group (P=0.009), but the curve of follow-up was similar in both groups; multiple interventions group had better follow-up (P<0.0001).ConclusionCurve of loss to follow-up is logarithmic in children undergoing paediatric cataract surgery. Age at surgery and low economic status are the most important factors associated with poor follow-up.

Efficacy of surgical treatment of traumatic cataract with simultaneous intraocular lens implantation in children

2013 ◽  
Vol 4 (1) ◽  
pp. 37-40
Author(s):  
Diloram Asrarovna Zakirkhodzhayeva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Eye Injury ◽  
Traumatic Cataract ◽  
Iol Implantation ◽  
Intraocular Injection ◽  
Lens Implantation ◽  
One Year

Background: eye injury is often accompanied by lens damage. Aim: To evaluate the efficacy of surgical treatment of traumatic cataract with simultaneous IOL implantation in children. Material and methods: The results of surgical treatment of traumatic cataract with simultaneous IOL implantation in 62 children were analyzed: in 48 boys (77.4%) and 14 girls (22.6%) with a mean age 8.1 years. Results: visual acuity after surgery gradually increased from 0.09 to 0.22 by the end of the first month, 0.43 in 6 months and 0.47 in one year of follow-up. In 85.5% of the operated children visual acuity in the late post-op period was accounted 0.3–1.0, and in 82.2% of cases binocular vision was recovered. In the early postoperative period following complications were observed: exudative iridocyclitis — 16.1%; deposits of fibrin in the pupil — 8%; pigment deposits on surface of the IOL — 19%; secondary cataract — 12%; IOL or its haptics dislocation — 3% cases. Conclusions: Early IOL implantation during traumatic cataract surgery in children is suitable. Use of viscoelastics allows minimizing the severity of postoperative inflammation and reducing a risk of complications. Intraocular injection of Gemasa during surgery is effective to resolve hyphema, intraocular hemorrhages and fibrinoid exudate.

scholarly journals Congenital and developmental cataract surgery with undercorrected Intraocular lens (IOL) power implantation targeting emmetropia at 8 years of age and post-operative refractive status

2021 ◽  
Vol 12 (9) ◽  
pp. 126-129
Author(s):  
Kabindra Bajracharya ◽  
Anjita Hirachan ◽  
Kriti Joshi ◽  
Bimala Bajracharya
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Iol Implantation ◽  
Refractive Status ◽  
Developmental Cataract ◽  
Iol Power ◽  
The Mean ◽  
One Year

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.

Evaluating Risk Factors of Glaucoma Following Paediatric Cataract Surgery

2009 ◽  
Vol 03 (01) ◽  
pp. 27
Author(s):  
Birgitte Haargaard ◽  
John Thygesen ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
High Risk ◽  
Cataract Surgery ◽  
Pressure Measurement ◽  
Axial Length ◽  
Early Age ◽  
Corneal Diameter ◽  
Paediatric Cataract

The risk of developing glaucoma after paediatric cataract surgery is substantial. A number of risk factors have been associated with the post-operative development of glaucoma, the most important and consistent one being age at the time of surgery. Glaucoma occurs in up to one-third of patients who have had cataract surgery at an early age (<9 months), with a particularly high risk when surgery is performed during the first four weeks of life. The discovery of glaucoma in children <2 years of age often requires additional measurements apart from the intraocular pressure measurement. Young children have elastic eye bulbs, and an increase in axial length, an increase in corneal diameter and/or an increase in excavation of the optic disc may be the only indication of glaucoma. The risk of glaucoma after paediatric cataract surgery continues throughout life, and it is therefore pertinent to perform glaucoma evaluation of these patients during follow-up.

scholarly journals Optical Biometry and Influence of Media Opacity Due to Cataract on Development of Axial Length in Pediatric Eyes

2021 ◽  
Author(s):  
Harsha Bhattacharjee ◽  
Suklengmung Buragohain ◽  
Henal Javeri ◽  
Saurabh Deshmukh
Keyword(s):  
Axial Length ◽  
Systemic Disease ◽  
Bilateral Cataract ◽  
Optical Biometry ◽  
Paediatric Outpatient ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Unilateral Cataract ◽  
Fellow Eyes

Abstract Aim: To study the influence of media opacity due to cataract on the development of axial length in paediatric eyes with the help of optical biometry.Method: In this prospective, observational study, all patients attending the paediatric outpatient department (OPD) of the institute underwent a comprehensive ocular and systemic evaluation. Patients suffering from any other ocular disease and systemic disease were excluded. Optical biometry was performed to measure the axial length in all the eyes. In each eye, five biometric measurements were acquired and average of these five readings were considered for the study. Patients were divided into three groups after proper age matching – 1. Group A (Bilateral cataract) 2. Group B (Unilateral cataract) 3. Group C (Bilateral normal). The axial length of the various groups were then compared. Results: A total of 540 eyes of 270 patients were involved in the study. 120 cases (n = 240 eyes) in Group A (bilateral cataract), 30 cases (n = 60 eyes) in Group B (unilateral cataract) and 120 (n = 240 eyes) in Group C (no cataracts). The mean age of the patients in all the groups was 9.38 ± 3.67 years (range: 1-17 years). In Group B, the difference in the AL between the cataractous eyes (22.44±1.48 mm; n = 30) and the fellow eyes (22.09±0.93 mm; n = 30) was not statistically significant (P = 0.277). The difference in the AL between the cataractous right eyes of Group A (22.9±3.51 mm, n = 120) and the non-cataractous right eye of Group C fellow eyes (22.57±0.71 mm, n = 120) was not statistically significant (P = 0.316). The difference in the AL between the cataractous left eyes of Group A (23.06±2.33 mm, n = 120) and the non-cataractous left eyes of Group C fellow eyes (22.56±0.78, n = 120) was statistically significant (P = 0.028). Conclusion: The results of our study and reported literature to date, seem to indicate a more significant role of genetic factors in comparison to media opacity, in the proportionate development of the AL.

scholarly journals Outcome of paediatric cataract surgery in Northwest Ethiopia: a retrospective case series

2018 ◽  
Vol 103 (1) ◽  
pp. 112-118 ◽  
Author(s):  
Mulusew Asferaw ◽  
Sisay Yoseph Mekonen ◽  
Geoffrey Woodruff ◽  
Clare E Gilbert ◽  
Samson Tesfaye
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Case Series ◽  
Northwest Ethiopia ◽  
Retrospective Case ◽  
Postoperative Rehabilitation ◽  
Bilateral Cataract ◽  
Eye Health ◽  
Paediatric Cataract

AimTo assess visual acuity outcomes, and factors associated with the outcome, of paediatric cataract surgery at the Child Eye Health Tertiary Facility, Gondar, Northwest Ethiopia.MethodsThe medical records of children aged below 16 years who underwent cataract surgery between September 2010 and August 2014 were reviewed for preoperative, surgical and postoperative data.ResultsOne hundred and seventy-six eyes of 142 children (mean age 7.9 years±4.2 SD, 66% male) who had cataract surgery were included. Twenty-five per cent (35/142) of children had bilateral cataract, 18 (13%) had unilateral non-traumatic cataracts and 89 (63%) had unilateral traumatic cataracts. An intraocular lens was implanted in 93% of eyes. Visual acuities at last follow-up: bilateral cases in the better eye: good (≥6/18 or fix and follow) in 21/34 eyes (62%), borderline (<6/18–6/60) in 4 eyes (12%) and poor (<6/60) in 9 eyes (26%). In unilateral non-traumatic cases: good in 6 eyes (33%), borderline in 3 eyes (17%) and poor in 9 eyes (50%). In unilateral traumatic cases: good in 36 eyes (40%), borderline in 20 eyes (23%) and poor in 33 eyes (37%). In bilateral cataract, worse outcomes were associated with preoperative nystagmus/strabismus. In traumatic cases, worse outcomes were associated with the preoperative trauma-related complications.ConclusionsVisual acuity improved significantly after surgery, with better outcomes in bilateral cases. Early detection and surgery by a trained surgeon with good follow-up and postoperative rehabilitation can lead to better visual outcomes.

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