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Kruglova T.B.

Helmholtz National Medical Research Center of Eye Diseases

Katargina L.A.

Helmholtz National Medical Research Center of Eye Diseases

Egiyan N.S.

Helmholtz National Medical Research Center of Eye Diseases

Trifonova O.B.

Helmholtz National Medical Research Center of Eye Diseases

Mamykina A.S.

Helmholtz National Medical Research Center of Eye Diseases

Long-term functional outcomes after congenital cataract extraction with intraocular lens implantation in children of the first year of life

Authors:

Kruglova T.B., Katargina L.A., Egiyan N.S., Trifonova O.B., Mamykina A.S.

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Journal: Russian Annals of Ophthalmology. 2020;136(6): 142‑146

DOI: 10.17116/oftalma2020136062142

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To cite this article:

Kruglova TB, Katargina LA, Egiyan NS, Trifonova OB, Mamykina AS. Long-term functional outcomes after congenital cataract extraction with intraocular lens implantation in children of the first year of life. Russian Annals of Ophthalmology. 2020;136(6):142‑146. (In Russ.)
https://doi.org/10.17116/oftalma2020136062142

Подписка 2025 (Russian Annals of Ophthalmology)
 
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PURPOSE

To study best corrected visual acuity (BCVA) and identify its relationship with various factors in eyes with pseudophakia in long-term periods after removal of congenital cataract (CC) in the first year of life.

MATERIAL AND METHODS

The study included 54 children (72 eyes) aged 4 to 12 years who had undergone CC removal with intraocular lens (IOL) implantation at the age of 2—11 months. Examination included: visual acuity testing, Flicker ERG 30 Hz electroretinography (MBN, Russia), optical coherence tomography (HRT-OCT) on the Heidelberg Spectralis (Heidelberg Engineering, Germany) platform.

RESULTS

The best results were obtained after removal of bilateral congenital cataract (BCC): BCVA in 58.0% of cases was 0.15—0.3, and in 12.0% of cases — 0.4—0.8. BCVA was 0.1 or less in 95.5% of cases and only one child had 0.2 after removal of unilateral congenital cataract (UCC). The best BCVA was achieved in children operated on the 2—5 month of age (BCVA more than 0.3 in 68.7%; only children from that group had 0.5—0.8), without any concomitant pathology and with normal indicators of ERG Flicker 30 Hz. Deviations from physiological formation of the macula were revealed using OCT. The direct relationship was shown between BCVA, and the maximal retinal thickness in parafovea and choroidal thickness in the subfoveal area.

CONCLUSION

BCVA significantly varies after CC removal with IOL implantation in infancy: 0.02—0.8. The main factors influencing BCVA in that case are: laterality of cataract, child age at the time of operation, duration of visual deprivation, concomitant eye pathology and refractive amblyopia accompanying incomplete correction of aphakia.

Keywords:

congenital cataract
pseudophakia
visual acuity
optical coherence tomography
concomitant eye pathology

Authors:

Kruglova T.B.

Helmholtz National Medical Research Center of Eye Diseases

Katargina L.A.

Helmholtz National Medical Research Center of Eye Diseases

Egiyan N.S.

Helmholtz National Medical Research Center of Eye Diseases

Trifonova O.B.

Helmholtz National Medical Research Center of Eye Diseases

Mamykina A.S.

Helmholtz National Medical Research Center of Eye Diseases

Received:

27.04.2020

Accepted:

08.07.2020

List of references:

  1. Katargina LA, Mikhailova LA. The current stage of the ophthalmological care service in the Russian Federation (2012—2013). Rossiyskaya pediatricheskaya oftal’mologiya. 2015;(1):5-10 (in Russ.).
  2. Katargina LA, Kruglova TB, Trifonova OB, Egiyan NS, Kogoleva LV, Arestova NN. Refraction of the pseudophakic eyes after surgical treatment of congenital cataracts. Vestnik oftal’mologii. 2019;134(1):35-40. (In Russ.). https://doi.org/10.17116/oftalma20191340135
  3. Kruglova TB, Kononov LB. Features of optical power calculation of intraocular lenses implanted in children with congenital cataracts in the first year of life. Vestnik oftal’mologii. 2013;129(4):66-69 (In Russ.).
  4. Chak M, Wade A, Rahi JS. Long-term visual acuity and its predictors after surgery for congenital cataract: findings of the British congenital cataract study. Invest Ophthalmol Vis Sci. 2006;10:4262-4269. https://doi.org/10.1167/iovs.05.1160
  5. Birch EE, Cheng C, Stager DR Jr, Felius J. Visual acuity development after the implantation of unilateral intraocular lenses in infants and young children. J AAPOS. 2005;(6):527-532.  https://doi.org/10.1016/j.jaapos.2005.07.008
  6. Ledoux DM, Trivedi RH, Wilson ME Jr, Payne JF. Pediatric cataract extraction with intraocular lens implantation: visual acuity outcome when measured at age four years and older. J AAPOS. 2007;(3):218-224.  https://doi.org/10.1016/j.jaapos.2006.11.003
  7. Zritel’nye funkcii i ih korrekciya u detej [Visual functions and their correction in children]. Eds Avetisov S.E., Kashchenko T.P., Shamshinova A.M. M.: Meditsina; 2005. (In Russ.).
  8. Izbrannye lekcii po detskoj oftal’mologii [Selected lectures on pediatric ophthalmology]. Ed. Neroev V.V. M.: GEOTAR-Media; 2009. (In Russ.).
  9. Detskaya oftal’mologiya [Pediatric ophthalmology]. Ed. Sidorenko E.I. M.: Izdatel’stvo Panfilova; 2015. (In Russ.).
  10. Lim Z, Rubab S, Chan YH, Levin AV. Management and outcomes of cataract in children: the Toronto experience. J AAPOS. 2012;3:249-254.  https://doi.org/10.1016/j.jaapos.2011.12.158
  11. Fu VL, Bilonick RA, Felius J, Hertle RW, Birch EE. Visual acuity development of children with infantile nystagmus syndrome. Invest Ophthalmol Vis Sci. 2011;3:1404-1411. https://doi.org/10.1167/iovs.09-4686
  12. Young MP, Heidary G, VanderVeen DK. Relationship between the timing of cataract surgery and development of nystagmus in patients with bilateral infantile cataracts. J AAPOS. 2012;6:554-557.  https://doi.org/10.1016/j.jaapos.2012.08.008
  13. Zhang H, Xie L, Wu X, Tian J. Long-term results of pediatric cataract surgery after delayed diagnosis. J AAPOS. 2012;1:65-69.  https://doi.org/10.1016/j.jaapos.2011.09.012
  14. Lambert SR. The timing of surgery for congenital cataracts: Minimizing the risk of glaucoma following cataract surgery while optimizing the visual outcome. J AAPOS. 2016;3:191-192.  https://doi.org/10.1016/j.jaapos.2016.04.003

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