Postoperative complications (early and late) after pediatric cataract surgery in Sohag University Hospital

Mohammed, Hany Fathi; Abdelatif, Ismael Moussa; Ismail, Ali Mahmoud; Ammar, Hatem

doi:10.21608/smj.2017.41413

Postoperative complications (early and late) after pediatric cataract surgery in Sohag University Hospital

Document Type : Original Article

Authors

¹ Department of Opthalmology, Sohag Faculty of Medicine, Sohag University

² Department of Ophthalmology, Faculty of Medicine, Sohag University.

10.21608/smj.2017.41413

Abstract

Introduction: Glaucoma is a recognized complication of pediatric cataract surgery. Despite improved surgical techniques, the incidence of glaucoma following successful cataract removal remains high. A significant number of surgeons regard aphakia as a cause of glaucoma. This glaucoma, however, may be better described as ‘glaucoma in aphakia and pseudophakia’. Other complications, retinal detachment. It was found that retinal detachment is infrequent following aphakia in pediatric cataract surgery, at least at short term follow-up. Corneal astigmatism is recognized as a problem arising from cataract surgery.
Aim of the work: To evaluate postoperative complications (early and late) after pediatric cataract surgery in Sohag University Hospital
Patients and Methods: A prospective, randomized study, patients were divided into 3 groups based on the surgical technique they had undergone. Group A "25 patients" : patients who have undergone Lensectomy anterior vitrectomy (LAV). GroupB"24patients": patients who have undergone Extracapsular cataract extraction, primary posterior capsulorhexis or capsulotomy, anterior vitrectomy, and IOL implantation (ECCE/PPC/AV/IOL). Group C"26patients": patients who have undergone Extracapsular Cataract Extraction and IOL Implantation (ECCE/IOL)
Results: Early postoperative complications were diagnosed in 34 eyes (35.1%). Postoperative iritis occurred in 7 eyes (7.2%) with mild inflammatory reaction. Striate keratopathy was found in 4 eyes (4.12 %) and cleared after frequent topical steroid application. Postoperative endophthalmitis: occurred in one eye in group A in the second postoperative day. Twenty-four hours later, 3 ports pars plana vitrectomy was done but unfortunately the eye passed into atrophia. Early IOL capture occurred in 2 eyes (2.1%) with PMMA IOL. Both patients belonged to group C. Both occurred in the second postoperative day. Postoperative retinal detachment (RD) occurred in one eye (1%) in group B, Posterior capsule opacification (PCO) occurred in 30 eyes (31%) during the first 3 months of follow up. Seven eyes (7.2%) belonged to group A. In group B, 5 eyes (5.1%) had PCO, Late IOL capture occurred in 9 eyes (9.3%). These included 5 eyes (5.2%) in group B; among them 4 eyes (4.1%) had been implanted PMMA IOL.
Conclusion: Complications after cataract surgery in children are often associated with a robust inflammatory reaction or secondary opacity and, in infants, glaucoma

Keywords

References

1. Vasavada AR, Praveen MR, Nath V, Dave K. Diagnosis and management of congenital cataract with preexisting posterior capsule defect. Journal of cataract and refractive surgery. 2004;30(2):403-8.

2. Chen MS, Ye YJ, Wang Y, Liu Y, Wu L, Luo WX. [Posterior continuous curvilinear capsulorhexis with optic capture of the posterior chamber intraocular lens in pediatric cataract]. [Zhonghua yan ke za zhi] Chinese journal of ophthalmology. 2006;42(5):400-2.

3. Bar-Sela SM, Spierer A. Astigmatism outcomes of scleral tunnel and clear corneal incisions for congenital cataract surgery. Eye. 2006;20(9):1044-8.

4. Weisberg OL, Sprunger DT, Plager DA, Neely DE, Sondhi N. Strabismus in pediatric pseudophakia. Ophthalmology. 2005;112(9):1625-8.

5. Stager DR, Jr., Wang X, Weakley DR, Jr., Felius J. The effectiveness of Nd:YAG laser capsulotomy for the treatment of posterior capsule opacification in children with acrylic intraocular lenses. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus. 2006;10(2):159-63.

6. Vishwanath M, Cheong-Leen R, Taylor D, Russell-Eggitt I, Rahi J. Is early surgery for congenital cataract a risk factor for glaucoma? Br J Ophthalmol. 2004;88(7):905-10.

7. Trivedi RH, Wilson ME, Jr., Golub RL. Incidence and risk factors for glaucoma after pediatric cataract surgery with and without intraocular lens implantation. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus. 2006;10(2):117-23.

8. Swamy BN, Billson F, Martin F, Donaldson C, Hing S, Jamieson R, et al. Secondary glaucoma after paediatric cataract surgery. Br J Ophthalmol. 2007;91(12):1627-30.

9. Michaelides M, Bunce C, Adams GG. Glaucoma following congenital cataract surgery--the role of early surgery and posterior capsulotomy. BMC Ophthalmol. 2007;7:13.

10. Khan AO. Emmetropization after lensectomy and anterior vitrectomy for persistent hyperplastic primary vitreous cataract. Eye Contact Lens. 2007;33(4):199-200.

11. Kirwan C, Lanigan B, O'Keefe M. Glaucoma in aphakic and pseudophakic eyes following surgery for congenital cataract in the first year of life. Acta ophthalmologica. 2010;88(1):53-9.

12. Ross A, Ross AH, Mohamed Q. Review and update of central serous chorioretinopathy. Current opinion in ophthalmology. 2011;22(3):166-73.