Incidence and risk factors of cataract following pediatric pars plana vitrectomy.

Purpose: To evaluate the incidence and risk factors for cataract following pediatric pars plana vitrectomy (PPV).

Setting: Tertiary referral center.

Design: Retrospective consecutive case series.

Methods: We included 242 eyes of 218 patients (< 18 years) that underwent lens-sparring PPV with a minimum follow-up of 6 months. Information regarding demographic and ophthalmic features, surgical history and procedures were gathered and analyzed. Eyes were evaluated for the development of cataract requiring surgery.

Results: Mean age at surgery was 6.8 ± 5.0 years and mean follow-up was 31.9 ± 37.5 months. After a mean interval of 17.0 ± 22.0 months, 80 eyes (33.1%) required lensectomy with posterior subcapsular cataract being the most common cataract type (76.3%). Overall, the risk of developing cataract after PPV increased from 21% at 1 year to 47% at 5 years The factor associated with the development of postoperative cataract were the need for multiple surgeries (58.8% vs. 13.6%, p < 0.001), the type of tamponade used p < 0.001), older age at surgery (101.9 ± 53.1 months vs. 71.0 ± 60.8 months, p < 0.001), and retinal detachment (78.8% vs. 19.1%, p < 0.001). Multivariate analysis including the aforementioned variables identified the need for multiple surgeries [OR: 2.7 (CI: 1.2-6.2), p = 0.02)] as a risk factor for the development post-PPV cataract while the use of air or no tamponade as protective (p = 0.001).

Conclusions: Post-PPV cataract is a common complication occurring in about one-third of children. Risk factors include silicone oil tamponade, gas tamponade and multiple surgeries. Follow-up should be started early and continued for an extended duration after PPV especially in young children at risk of developing amblyopia.