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Abstract
PURPOSE: To evaluate outcomes of bilateral cataract surgery in children ages 7-24 months and compare rates of adverse events (AE) to other Toddler Aphakia and Pseudophakia Study (TAPS) registry outcomes.DESIGN: Retrospective clinical study at 10 IATS sites. Statistical analyses comparing this cohort to previously reported TAPS registry cohorts.PARTICIPANTS: Children enrolled in the TAPS registry between 2004 and 2010.INTERVENTION: Children underwent bilateral cataract surgery with or without intraocular lens (IOL) placement at age 7-24 months with 5 years of post-surgical follow-up.MAIN OUTCOME MEASURES: Visual acuity, occurrence of strabismus, adverse events (AE), reoperations.RESULTS: 40 children (76 eyes) who underwent bilateral cataract surgery with primary posterior capsulectomy were identified with a median age at cataract surgery of 13 months (7-23); 68% received a primary intraocular lens (IOL). Recurrent visual axis opacification (VAO) occurred in 7.5% and was associated only with the use of an IOL (Odds Ratio 6.10, p=0.005). Glaucoma suspect (GS) was diagnosed in 2.5%, but no child developed glaucoma. In this bilateral cohort, AEs (8/40, 20%), including glaucoma or GS and VAO, and reoperations occurred in a similar proportion to that of the published unilateral TAPS cohort. When analyzed with children 1-7 months at bilateral surgery, the incidence of AEs and glaucoma or GS correlated strongly with age at surgery (p=0.011/0.004) and glaucoma correlated with microcornea (p=0.040) but not with IOL insertion (p=0.15).CONCLUSIONS: Follow-up to age 5 years after bilateral cataract surgery in children 7-24 months reveals a low rate of VAO and very rare glaucoma or GS diagnosis compared to infants with cataracts operated < 7 months of age despite primary IOL implantation in most children in the 7-24 months group. The use of an IOL increases the risk of VAO irrespective of age at surgery.
View details for DOI 10.1016/j.ophtha.2020.07.020
View details for PubMedID 32679160