.: ORİJİNAL ARAŞTIRMA
Evaluation of Factors Affecting the Results of Pediatric Cataract Surgery: A Retrospective Case Series
Pediatrik Katarakt Cerrahisi Sonuçlarını Etkileyen Faktörlerin Değerlendirilmesi: Retrospektif Olgu Serisi
Turkiye Klinikleri J Ophthalmol. 2025;34(3):104-12
doi: 10.5336/ophthal.2024-107712
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To evaluate the effect of various factors, including age, laterality, surgical technique used, intraocular lens (IOL) implantation site, and target refraction, on the long-term outcomes of pediatric cataract surgery. Material and Methods: This single-center, retrospective case series included 74 eyes of 50 patients who underwent surgery for pediatric cataract. Patients were divided into subgroups: Group I [posterior continuous curvilinear capsulorhexis (PCCC) combined with anterior vitrectomy (AV) and aphakic follow-up], Group II (PCCC combined with AV and IOL implantation), Group III (IOL implantation only without PCCC and AV). Patients were also divided into 4 subgroups according to the age at primary surgery as Group A (0-3 months), Group B (3-12 months), Group C (12-24 months), and Group D (24 months and over). Results: The mean age of all patients was 55.90±48.0 months. Thirteen (81.25%) eyes in Group I had visual acuity of 0.1 or less, 28 (65.1%) eyes in Group II had visual acuity between 0.1-0.5-9 (60.0%) eyes in Group III had visual acuity of 0.5 or more (p<0.001). Secondary glaucoma was detected in 15 (20.3%) eyes and it was significantly higher in the ciliary sulcus group (n=8, 29.6%) than in the capsular bag group (n=2, 6.5%) (p=0.042). Posterior capsuler opacity was observed in 8 (10.8%) eyes, including 1 (2%) eye in Group II and 7 (46.6%) eyes in Group III (p<0.001). Conclusion: The surgical technique used, the location of IOL implantation, the timing of secondary IOL implantation and determination of target refraction are extremely critical in pediatric cataracts.
Keywords: Congenital cataract; pediatric cataract; posterior capsule opacification; secondary glaucoma; visual outcomes
Objective: To evaluate the effect of various factors, including age, laterality, surgical technique used, intraocular lens (IOL) implantation site, and target refraction, on the long-term outcomes of pediatric cataract surgery. Material and Methods: This single-center, retrospective case series included 74 eyes of 50 patients who underwent surgery for pediatric cataract. Patients were divided into subgroups: Group I [posterior continuous curvilinear capsulorhexis (PCCC) combined with anterior vitrectomy (AV) and aphakic follow-up], Group II (PCCC combined with AV and IOL implantation), Group III (IOL implantation only without PCCC and AV). Patients were also divided into 4 subgroups according to the age at primary surgery as Group A (0-3 months), Group B (3-12 months), Group C (12-24 months), and Group D (24 months and over). Results: The mean age of all patients was 55.90±48.0 months. Thirteen (81.25%) eyes in Group I had visual acuity of 0.1 or less, 28 (65.1%) eyes in Group II had visual acuity between 0.1-0.5-9 (60.0%) eyes in Group III had visual acuity of 0.5 or more (p<0.001). Secondary glaucoma was detected in 15 (20.3%) eyes and it was significantly higher in the ciliary sulcus group (n=8, 29.6%) than in the capsular bag group (n=2, 6.5%) (p=0.042). Posterior capsuler opacity was observed in 8 (10.8%) eyes, including 1 (2%) eye in Group II and 7 (46.6%) eyes in Group III (p<0.001). Conclusion: The surgical technique used, the location of IOL implantation, the timing of secondary IOL implantation and determination of target refraction are extremely critical in pediatric cataracts.
Keywords: Congenital cataract; pediatric cataract; posterior capsule opacification; secondary glaucoma; visual outcomes
ÖZET
Amaç: Yaş, taraf, kullanılan cerrahi teknik, göz içi lens (GİL) implantasyon bölgesi ve hedef refraksiyon gibi çeşitli faktörlerin pediatrik katarakt cerrahisinin uzun dönem sonuçları üzerindeki etkisini değerlendirmek. Gereç ve Yöntemler: Bu tek merkezli, retrospektif olgu serisine pediatrik katarakt cerrahisi geçiren 50 hastanın 74 gözü dâhil edildi. Hastalar alt gruplara ayrıldı: Grup I [ön vitrektomi (ÖV) ve afakik takip ile birlikte arka sürekli eğrisel kapsüloreksis (posterior continuous curvilinear capsulorhexis-PCCC)], Grup II (ÖV ve GİL implantasyonu ile birlikte PCCC), Grup III (PCCC ve ÖV olmadan sadece GİL implantasyonu). Hastalar ayrıca primer cerrahi yaşına göre Grup A (0-3 ay), Grup B (3-12 ay), Grup C (12-24 ay) ve Grup D (24 ay ve üzeri) olmak üzere 4 alt gruba ayrıldı. Bulgular: Ortalama hasta yaşı 55,90±48,0 aydı. Grup I'deki 13 (%81,25) gözde görme keskinliği 0,1 veya daha az, Grup II'deki 28 (%65,1) gözde görme keskinliği 0,1- 0,5 arasında ve Grup III'teki 9 (%60,0) gözde görme keskinliği 0,5 veya daha fazla idi (p<0,001). Sekonder glokom 15 (%20,3) gözde saptandı ve siliyer sulkus grubunda (n=8, %29,6) kapsüler kese grubuna (n=2, %6,5) göre anlamlı derecede yüksekti (p=0,042). Grup II'de 1 (%2) gözde ve Grup III'te 7 (%46,6) gözde olmak üzere toplam 8 (%10,8) gözde arka kapsül opasifikasyonu gözlenmiştir (p<0,001). Sonuç: Pediatrik kataraktlarda kullanılan cerrahi teknik, GİL implantasyonunun yeri, sekonder GİL implantasyonunun zamanlaması ve hedef refraksiyonun belirlenmesi son derece kritiktir.
Anahtar Kelimeler: Konjenital katarakt; pediatrik katarakt; arka kapsül opasifikasyonu; sekonder glokom; görsel sonuçlar
Amaç: Yaş, taraf, kullanılan cerrahi teknik, göz içi lens (GİL) implantasyon bölgesi ve hedef refraksiyon gibi çeşitli faktörlerin pediatrik katarakt cerrahisinin uzun dönem sonuçları üzerindeki etkisini değerlendirmek. Gereç ve Yöntemler: Bu tek merkezli, retrospektif olgu serisine pediatrik katarakt cerrahisi geçiren 50 hastanın 74 gözü dâhil edildi. Hastalar alt gruplara ayrıldı: Grup I [ön vitrektomi (ÖV) ve afakik takip ile birlikte arka sürekli eğrisel kapsüloreksis (posterior continuous curvilinear capsulorhexis-PCCC)], Grup II (ÖV ve GİL implantasyonu ile birlikte PCCC), Grup III (PCCC ve ÖV olmadan sadece GİL implantasyonu). Hastalar ayrıca primer cerrahi yaşına göre Grup A (0-3 ay), Grup B (3-12 ay), Grup C (12-24 ay) ve Grup D (24 ay ve üzeri) olmak üzere 4 alt gruba ayrıldı. Bulgular: Ortalama hasta yaşı 55,90±48,0 aydı. Grup I'deki 13 (%81,25) gözde görme keskinliği 0,1 veya daha az, Grup II'deki 28 (%65,1) gözde görme keskinliği 0,1- 0,5 arasında ve Grup III'teki 9 (%60,0) gözde görme keskinliği 0,5 veya daha fazla idi (p<0,001). Sekonder glokom 15 (%20,3) gözde saptandı ve siliyer sulkus grubunda (n=8, %29,6) kapsüler kese grubuna (n=2, %6,5) göre anlamlı derecede yüksekti (p=0,042). Grup II'de 1 (%2) gözde ve Grup III'te 7 (%46,6) gözde olmak üzere toplam 8 (%10,8) gözde arka kapsül opasifikasyonu gözlenmiştir (p<0,001). Sonuç: Pediatrik kataraktlarda kullanılan cerrahi teknik, GİL implantasyonunun yeri, sekonder GİL implantasyonunun zamanlaması ve hedef refraksiyonun belirlenmesi son derece kritiktir.
Anahtar Kelimeler: Konjenital katarakt; pediatrik katarakt; arka kapsül opasifikasyonu; sekonder glokom; görsel sonuçlar
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