Visual Acuity and Its Predictors After Surgery for Bilateral Cataracts in Children
Narrative Responses:
Purpose
To report visual acuity (VA) outcomes when cataract surgery is performed on both eyes in children and to develop a model to predict VA outcome.
Methods
Subjects were included if they had undergone bilateral cataract extraction at <18 years of age. Postoperative VA was separated into 4 categories, ‘excellent’ (Snellen VA > 20/25), ‘good’ (<20/25 but ≥20/40), ‘fair’ (<20/40 but ≥20/100), and ‘poor’ (< 20/100). Descriptive statistics and logistic regression were performed in the data analysis. A multivariate model was constructed to predict the odds of worse visual acuity based on preoperative variables.
Results
N=157 (314 eyes). Median VA of eye with better vision was 20/30(20/40, 20/30, 20/25 and 20/25 for children operated at <1, 1-4, 4-8, and >8 years of age, respectively). Median VA of eye with worse vision was 20/40(20/60, 20/40, 20/30 and 20/25 for children operated for cataract at <1, 1-4, 4-8, >8 years of age respectively). For categorical model, there was a increase in odds of good postoperative VA among individuals without preoperative nystagmus and with primary IOL implantation. For the continuous multivariate analysis using the LogMAR of postoperative VA, preoperative nystagmus was the only variable found to be significant.
Conclusion
Better visual prognosis appears to be associated with the absence of preoperative nystagmus.