Congenital cataract surgery best performed within first 10 weeks of life

ORLANDO, Fla. — Pediatric cataract surgery should be performed within the first 10 weeks of life in infants with bilateral congenital cataract, said Scott R. Lambert, MD, speaking here.

“Good visual outcomes can be achieved when performing surgery on a child who is 10 weeks old or younger. But delaying surgery increases the risk of poor visual outcomes,” Dr. Lambert told attendees at the American Association for Pediatric Ophthalmology and Strabismus meeting. He said that children with bilateral congenital cataract typically develop ocular nystagmus after 10 weeks of age, so it is crucial to perform cataract surgery before they develop nystagmus to preserve good vision.

Dr. Lambert presented a study of 45 children with dense bilateral congenital cataract who underwent cataract surgery within the first 35 weeks of life (mean 12.3 weeks). Fifty-seven percent of the patients achieved a best corrected visual acuity of 20/40 or better, 29% achieved a VA of 20/50 to 20/80 and 14% achieved VA of 20/100 or worse.

Children who underwent cataract surgery after 10 weeks of age had a higher rate of poor visual acuity (20/100 or worse) than children who underwent cataract surgery within the first 10 weeks of life, Dr. Lambert said.

“While previous reports have suggested that cataract surgery should be performed within the first 8 weeks of life, our study found that there is no well-defined latent period and no advantage to performing surgery at any point in the first 10 weeks of life,” he added.