Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications

Abstract

The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intra operative and postoperative complications. Mean age at surgery was 10.18 , 3.21 years. Mean follow up length was 15.75 , 3.36 weeks. Etiology included: 10 congenital cataract (16.12%). 35 developmental cataracts (56.45%) and 17traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ,0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 , 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ,3.169 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were leftaphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intra operative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses sub luxation and 1 case of iris dialyse. Late post operative complications included: posterior capsular opacity which occurred in 16 patient, 3 posterior synechia, 2 retina detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.

Keywords

• pediatric cataract
• local anesthesia
• intraocular lenses
• postoperative complications