Long-term outcome and determinants of primary pediatric cataract surgery.

Purpose: This study aimed to evaluate the long-term outcomes of primary pediatric cataract surgery and to identify determinants of success and recommendations to improve the care of patients with pediatric cataracts.

Methods: A cohort, retrospective study of cases who were operated as primary pediatric cataract surgery at King Khaled Eye Specialist Hospital. Patients who are 4 years old or younger and underwent primary cataract surgery with at least 3-year follow-up were enrolled in this study. Preoperative and postoperative evaluations were performed to determine the surgery outcomes.

Results: Two hundred and two eyes of 119 patients were enrolled in the study. Seventy percentage of the patients were diagnosed with bilateral cataracts and 30% with unilateral cataracts. Postoperative evaluation showed that 20% of the patients had best corrected visual acuity of 20/30 or better, 25% had 20/40-20/50, 20% had 20/60-20/80, and 29% had 20/100 or less, 6% as fixate and follow. In addition, the mean spherical equivalent was 1.50D. Amblyopia was present in 120 eyes. Fourteen percentage showed a significant myopic shift of more than -4.00D and it was more in eyes with primary intraocular lens (IOL) implantation. Glaucoma was reported in 19% of the patients.

Conclusion: There was a significant postoperative myopic shift and it was more in eyes with primary IOL implantation. Glaucoma was the most common reported postoperative complication. The presence of strabismus and nystagmus may affect the visual outcomes. Early intervention might reduce the incidence of amblyopia.