With caution, cataract surgery can yield good results in children with microcornea

SEATTLE — Early cataract surgery in pediatric patients with microcornea appears to produce favorable visual outcomes, according to a study presented here. However, postoperative complications are of concern in these patients, especially glaucoma, the authors noted.

Sachiko Nishina, MD, and colleagues at the National Center for Child Health and Development in Tokyo reviewed the charts of 22 eyes of 11 children, all of whom underwent limbal approach lensectomy and anterior vitrectomy within 12 weeks after birth. They reported their study results in a poster at the American Association for Pediatric Ophthalmology and Strabismus meeting.

Children averaged 7.7 weeks old at the time of surgery and follow-up ranged from 3 to 16 years.

In addition to microcornea, other preoperative ocular abnormalities included iris hypoplasia in 10 eyes and persistent fetal vasculature in three eyes. Four children also had systemic abnormalities, according to the study.

Postoperatively, six children achieved binocular visual acuity of 20/60 to 20/20, two children achieved 20/200 to 20/100, and three children achieved 20/100 or worse, the authors reported.

Eleven of the 22 eyes experienced postoperative complications, including glaucoma in nine eyes, exudative retinal detachment in two eyes, rhegmatogenous retinal detachment in one eye and secondary pupillary membrane in one eye, according to the study.

The researchers concluded that, despite microcornea, patients with congenital cataracts could achieve good visual acuity, but that postoperative complications are of concern.