Long-Term Longitudinal Assessment of Postoperative Outcomes After Congenital Cataract Surgery in Children With Congenital Rubella Syndrome

Srivastava, Samaresh

Long-Term Longitudinal Assessment of Postoperative Outcomes After Congenital Cataract Surgery in Children With Congenital Rubella Syndrome

Sunday, April 27, 2014: 8:51 AM

Room 155 (Boston Convention and Exhibition Center)

Samaresh Srivastava, DNB, Iladevi Cataract & IOL Research Centre, Ahmedabad, India

Sajani K. Shah, MS, Iladevi Cataract & IOL Research, Ahmedabad, India

Mamidipudi R. Praveen, MS, Iladevi Cataract &IOL Research Centre, Ahmedabad, Gujarat, India

Vaishali Vasavada, MS, Iladevi Cataract & IOL Research Centre, Ahmedabad, India

Abhay R. Vasavada, MS, FRCS, Iladevi Cataract & IOL Research, Ahmedabad, Gujarat, India

Roberta Carelli, MD, University of Salerno, Salerno, Italy

Narrative Responses:

Purpose
To evaluate intraoperative performance and long-term postoperative outcomes after cataract surgery in children with congenital rubella syndrome (CRS).

Methods
A prospective interventional case series comprising 37 eyes(21 children) with CRS who underwent cataract surgery. Microcornea defined as a horizontal corneal diameter less than/equal to 9mm. A standardized surgical technique was followed throughout the study. All microphthalmic eyes were left aphakic. A single-piece hydrophobic acrylic IOL was implanted inside the capsular bag in eyes without microphthalmos. Intraoperative complications were documented. All children were followed up every 6 months upto 5 years postoperatively. The postoperative observations :t every follow-up were posterior synechiae, visual axis obscuration(VAO), glaucoma, and other complications. Complete orthoptic and visual assessment was also performed at each postoperative visit

Results
The mean age of 21 children was 3.97±2.1months. IOL implantation was performed in 12(32.4%) eyes while 25(67.6%) eyes were left aphakic. At final followup, posterior synechiae were seen in 22(59.5%) eyes, VAO in 9(24.3 %) eyes of which 6 eyes underwent secondary procedure, secondary glaucoma in 16(43.2 %) eyes of which 14 eyes were aphakic.Of these 14 aphakic eyes,8 eyes had microphthalmos with microcornea and 9 eyes required trabeculectomy.A statistically significant impact of age at surgery and associated ocular comorbidity was documented for secondary glaucoma(chi-square tess(x² < 0.05)and Kendall’s Tau-B criteria(p<0.05)).Mean visual acuity at final followup(LogMAR)was 0.72±0.56

Conclusion
The long-term results suggest good visual outcomes can be obtained following congenital cataract after early surgical intervention in eyes with congenital rubella syndrome with an acceptable rate of serious postoperative complications.