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BMC Ophthalmology Mar 2019Congenital cataract is currently one of the leading blindness-causing eye diseases in children. Surgical treatment only opens the visual pathway for children. The...
Evaluation of eye-related parameters and adverse events of rigid gas permeable contact lens and spectacles correction in infants with monocular aphakia after congenital cataract surgery: a retrospective clinical study.
BACKGROUND
Congenital cataract is currently one of the leading blindness-causing eye diseases in children. Surgical treatment only opens the visual pathway for children. The postoperative recovery of visual function is also dependent on effective optical correction and visual function training. In this study, we analyzed the changes in eye-related parameters, adverse events and the annual cost of rigid gas permeable contact lens (RGPCL) and spectacles correction in infants with monocular aphakia after congenital cataract surgery.
METHODS
To analyze the postoperative visual acuity, strabismus, nystagmus, myopic shift, globe axial length growth, adverse events, patient adherence to patching, and annual cost for patients with unilateral congenital cataract who underwent cataract surgery. Rigid gas permeable contact lenses or spectacles were used to correct aphakia after congenital cataract.
RESULTS
Of the 49 patients, 20 patients with unilateral aphakia who used RGPCL were in group 1. Group 2 comprised 14 patients with persistent fetal vasculature (PFV) who used RGPCL, and there were 15 patients with spectacles in group 3. In group 1, there were important improvements in visual acuity, strabismus and nystagmus. In groups 2 and 3, there were no significant improvements in visual acuity, strabismus or nystagmus. Patients with a good adherence to patching had better visual acuity after the operation than patients who did not, in groups 1 and 3. There were no significant differences in myopic shift or rate of globe axial length growth among the 3 groups. No patients in group 1 had ocular disease that affected visual acuity. The mean annual expenses of the RGPCL group was 3965 yuan, and the mean annual cost of spectacles was 1140 yuan to 2500 yuan.
CONCLUSION
RGPCL is a safe and effective optical correction method for patients with monocular aphakia after congenital cataract surgery. Spectacles are not an ideal optical correction. Using RGPCL to correct patients with PFV, the final visual acuity improved, but the difference was not statistically significant. There were no improvements in strabismus or nystagmus in patients with PFV.
Topics: Aphakia, Postcataract; Axial Length, Eye; Cataract; Child; Child, Preschool; Contact Lenses; Eyeglasses; Female; Humans; Infant; Male; Myopia; Nystagmus, Pathologic; Retrospective Studies; Strabismus; Visual Acuity
PubMed: 30894149
DOI: 10.1186/s12886-019-1088-z -
Clinical Ophthalmology (Auckland, N.Z.) 2021To describe surgical technique and report short-term visual outcomes after suture-fixation of a single-piece eyelet-toric (SET) intraocular lens (IOL) for treatment of...
PURPOSE
To describe surgical technique and report short-term visual outcomes after suture-fixation of a single-piece eyelet-toric (SET) intraocular lens (IOL) for treatment of concurrent aphakia and astigmatism.
DESIGN
Retrospective, noncomparative, and non-consecutive case series.
METHODS
This was a case series of eleven eyes who underwent successful SET. Eligible eyes had loss of capsular support or aphakia with a minimum of symmetric corneal astigmatism 1.75 diopters (D). Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), magnitude of residual refractive cylinder, and complications resulting from the SET procedure.
RESULTS
Preoperative UDVA and CDVA in logMAR scale were 1.46 and 0.45, respectively. Mean preoperative keratometric and refractive cylinder were 3.67 D and 2.52D, respectively. Postoperative UDVA and CDVA were 0.51 and 0.27, respectively, three months after surgery (POM3). Residual refractive cylinder at POM3 was 0.93 D.
CONCLUSION
SET technique reduced refractive cylinder and improved UDVA and CDVA. SET may be adapted by surgeons using a readily available IOL and familiar scleral-fixation maneuvers.
PubMed: 34113075
DOI: 10.2147/OPTH.S311706 -
Indian Journal of Ophthalmology May 1982
Topics: Aphakia; Cataract; Corneal Diseases; Glaucoma; Humans; Retrospective Studies
PubMed: 7174052
DOI: No ID Found -
Indian Journal of Ophthalmology Oct 1981
Topics: Aphakia, Postcataract; Cataract Extraction; Follow-Up Studies; Glaucoma; Humans; Parasympathomimetics; Postoperative Complications
PubMed: 7346431
DOI: No ID Found -
JAMA Ophthalmology Apr 2023Glaucoma can develop following cataract removal in children.
IMPORTANCE
Glaucoma can develop following cataract removal in children.
OBJECTIVE
To assess the cumulative incidence of glaucoma-related adverse events (defined as glaucoma or glaucoma suspect) and factors associated with risk of these adverse events in the first 5 years after lensectomy prior to 13 years of age.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study used longitudinal registry data collected at enrollment and annually for 5 years from 45 institutional and 16 community sites. Participants were children aged 12 years or younger with at least 1 office visit after lensectomy from June 2012 to July 2015. Data were analyzed from February through December 2022.
EXPOSURES
Usual clinical care after lensectomy.
MAIN OUTCOMES AND MEASURES
The main outcomes were cumulative incidence of glaucoma-related adverse events and baseline factors associated with risk of these adverse events.
RESULTS
The study included 810 children (1049 eyes); 443 eyes of 321 children (55% female; mean [SD] age, 0.89 [1.97] years) were aphakic after lensectomy, and 606 eyes of 489 children (53% male; mean [SD] age, 5.65 [3.32] years) were pseudophakic. The 5-year cumulative incidence of glaucoma-related adverse events was 29% (95% CI, 25%-34%) in 443 eyes with aphakia and 7% (95% CI, 5%-9%) in 606 eyes with pseudophakia; 7% (95% CI, 5%-10%) of aphakic eyes and 3% (95% CI, 2%-5%) of pseudophakic eyes were diagnosed as glaucoma suspect. Among aphakic eyes, a higher risk for glaucoma-related adverse events was associated with 4 of 8 factors, including age less than 3 months (vs ≥3 months: adjusted hazard ratio [aHR], 2.88; 99% CI, 1.57-5.23), abnormal anterior segment (vs normal: aHR, 2.88; 99% CI, 1.56-5.30), intraoperative complications at time of lensectomy (vs none; aHR, 2.25; 99% CI, 1.04-4.87), and bilaterality (vs unilaterality: aHR, 1.88; 99% CI, 1.02-3.48). Neither of the 2 factors evaluated for pseudophakic eyes, laterality and anterior vitrectomy, were associated with risk of glaucoma-related adverse events.
CONCLUSIONS AND RELEVANCE
In this cohort study, glaucoma-related adverse events were common after cataract surgery in children; age less than 3 months at surgery was associated with elevated risk of the adverse events in aphakic eyes. Children with pseudophakia, who were older at surgery, less frequently developed a glaucoma-related adverse event within 5 years of lensectomy. The findings suggest that ongoing monitoring for the development of glaucoma is needed after lensectomy at any age.
Topics: Child; Humans; Male; Female; Infant; Child, Preschool; Pseudophakia; Incidence; Cohort Studies; Aphakia, Postcataract; Intraocular Pressure; Cataract Extraction; Glaucoma; Cataract; Ocular Hypertension
PubMed: 36795393
DOI: 10.1001/jamaophthalmol.2022.6413 -
Saudi Journal of Ophthalmology :... 2021Congenital aniridia is a rare ocular disorder characterized by iris malformation. We present a 3-year-old boy with bilateral anterior-segment dysgenesis, congenital...
Congenital aniridia is a rare ocular disorder characterized by iris malformation. We present a 3-year-old boy with bilateral anterior-segment dysgenesis, congenital aniridia, congenital aphakia, secondary glaucoma, limbal stem cell deficiency, and band keratopathy. As the intraocular pressure was uncontrolled with antiglaucoma medications, the patient underwent multiple bilateral traditional cyclophotocoagulation (CPC), in addition to micropulse CPC. To the best of our knowledge, aniridia association with congenital aphakia and congenital glaucoma has been very rarely reported.
PubMed: 35814998
DOI: 10.4103/1319-4534.347313 -
Indian Journal of Ophthalmology Feb 2018
Topics: Aphakia; Corneal Transplantation; Humans
PubMed: 29380803
DOI: 10.4103/ijo.IJO_694_17 -
Indian Journal of Ophthalmology Jun 2022Visual rehabilitation in aphakia can be performed using several modalities. However, these modalities could be either technically difficult or expensive. Herein, we...
PURPOSE
Visual rehabilitation in aphakia can be performed using several modalities. However, these modalities could be either technically difficult or expensive. Herein, we developed a scleral tuck lens to provide a simple and cost-effective solution for aphakia and compared its outcome with standard methods.
METHODS
A specially designed posterior chamber self-sustaining lens was implanted in patients with aphakia without capsular support because of different primary etiologies. The visual outcomes, as well as intraoperative and postoperative complications, were examined. The data were retrieved from electronic medical records, and visual outcome and complication rates were compared. The outcomes were also compared according to the etiology and age groups (pediatric and adults).
RESULTS
We found significant improvement in preoperative and postoperative visual outcome. We did not find any significant difference in visual outcome amongst suture-supported scleral fixated lens with scleral tuck lens.
CONCLUSION
Satisfactory visual outcomes were noted with minimal complications; and comparable with gold standard suture fixated lens, however long-term follow-up is required.
Topics: Adult; Aphakia; Child; Humans; Lens Implantation, Intraocular; Retrospective Studies; Suture Techniques; Sutures; Visual Acuity
PubMed: 35647970
DOI: 10.4103/ijo.IJO_2320_21 -
British Medical Journal (Clinical... Oct 1987
Review
Topics: Aphakia; Humans; Keratotomy, Radial; Myopia; Refractive Surgical Procedures
PubMed: 3120886
DOI: 10.1136/bmj.295.6606.1081 -
Journal of Cataract and Refractive... Apr 2021Prediction of refraction after cataract surgery in children is limited by the variance in rate of refractive growth (RRG3). This study compared RRG3 in aphakic and... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Prediction of refraction after cataract surgery in children is limited by the variance in rate of refractive growth (RRG3). This study compared RRG3 in aphakic and pseudophakic eyes with their fellow, normal eyes in the Infant Aphakia Treatment Study.
SETTING
Twelve clinical sites in the United States.
DESIGN
Randomized clinical trial.
METHODS
Infants randomized to unilateral cataract extraction had RRG3 calculated based on biometric data (axial length and keratometry) at cataract surgery and at 10 years of age, for both the normal and cataract eyes. Subjects were included if complete biometric data from both eyes were available both at surgery and at 10 years. Variance in RRG3 was compared between the groups with Pitman test for equality of variance between correlated samples.
RESULTS
Longitudinal biometric data were available for 103 of the 114 patients enrolled. RRG3 was -15.00 diopters (D) (3.00 D) for normal eyes (reported as mean [SD]), -17.70 D (6.20 D) for aphakic eyes, and -16.70 D (6.20 D) for pseudophakic eyes (P < .0001 for comparison of variances in RRG3 between normal and all operated eyes). Further analysis found differences in the variance in axial length growth (P < .0001) between operated and normal eyes; the variance in keratometry measurement change did not reach significance.
CONCLUSIONS
The standard deviation in the RRG3 of normal eyes in our study was half of that found in eyes that underwent cataract surgery.
Topics: Aphakia; Aphakia, Postcataract; Cataract; Cataract Extraction; Cornea; Follow-Up Studies; Humans; Infant; Lens Implantation, Intraocular; Retrospective Studies
PubMed: 33181631
DOI: 10.1097/j.jcrs.0000000000000482