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Surgical outcomes of congenital and developmental cataracts in Japan

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Abstract

Purpose

To retrospectively analyze the surgical outcomes of congenital/developmental cataracts in Japan.

Methods

A mail questionnaire was sent to facilities engaged in surgical treatment of congenital cataracts.

Results

Twenty-nine facilities reported on 809 eyes of 508 patients with congenital/developmental cataracts. Three hundred fifty-nine eyes underwent intraocular lens implantation (pseudophakia group), while 450 eyes were left aphakic (aphakia group). The average age at surgery was significantly higher in the pseudophakia group (70 ± 53 months) than in the aphakia group (14 ± 24 months) (P < 0.0001). A significantly larger proportion of patients with unilateral cataract (52.0 %) received IOL implantation than did those with bilateral cataracts (42.6 %) (P = 0.0224). The prevalence of associated ocular disorders, such as nystagmus, microcornea, nanophthalmos, and persistent fetal vasculature, was significantly higher in the aphakia group than in the pseudophakia group. Postoperatively, glaucoma developed more frequently in the aphakia group (5.8 %) than in the pseudophakia group (0.7 %) (P = 0.0003). Posterior capsule opacification developed more frequently in the pseudophakic eyes even when both posterior capsulotomy and anterior vitrectomy were performed, especially in patients aged 1 year or younger. Postoperative visual acuity was significantly better in the pseudophakia group than in the aphakia group, both in the unilateral and in the bilateral cases.

Conclusions

Surgeons tended to select IOL implantation, rather than to leave the eye aphakic, in patients who were older at the time of surgery, had fewer coexisting ocular disorders, and suffered from unilateral cataract. Under such circumstances, pseudophakic eyes obtained significantly better postoperative visual acuity than did aphakic eyes.

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References

  1. Vanderveen DK, Trivedi RH, Nizam A, Lynn MJ, Lambert SR, Infant Aphakia Treatment Study Group. Predictability of intraocular lens power calculation formulae in infantile eyes with unilateral congenital cataract: results from the Infant Aphakia Treatment Study. Am J Ophthalmol. 2013;156:125–60.

    Article  Google Scholar 

  2. Trivedi RH, Lambert SR, Lynn MJ, Wilson ME, Infant Aphakia Treatment Study Group. The role of preoperative biometry in selecting initial contact lens power in the Infant Aphakia Treatment Study. J AAPOS. 2014;18:251–4.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Felius J, Busettini C, Lynn MJ, Hartmann EE, Lambert SR, Infant Aphakia Treatment Study Group. Nystagmus and related fixation instabilities following extraction of unilateral infantile cataract in the Infant Aphakia Treatment Study (IATS). Invest Ophthalmol Vis Sci. 2014;55:5332–7.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wall PB, Lee JA, Lynn MJ, Lambert SR, Traboulsi EI, Infant Aphakia Treatment Study Group. The effects of surgical factors on postoperative astigmatism in patients enrolled in the Infant Aphakia Treatment Study (IATS). J AAPOS. 2014;18:441–5.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hartmann EE, Lynn MJ, Lambert SR, Infant Aphakia Treatment Study Group. Baseline characteristics of the infant aphakia treatment study population: predicting recognition acuity at 4.5 years of age. Invest Ophthalmol Vis Sci. 2014;56:388–95.

    Article  PubMed  Google Scholar 

  6. Plager DA, Lynn MJ, Buckley EG, Wilson ME, Lambert SR, Infant Aphakia Treatment Study Group. Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the Infant Aphakia Treatment Study. Am J Ophthalmol. 2014;158:892–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Infant Aphakia Treatment Study Group, Lambert SR, Lynn MJ, Hartmann EE, DuBois L, Drews-Botsch C, et al. Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years. JAMA Ophthalmol. 2014;132:676–82.

    Article  Google Scholar 

  8. Hartmann EE, Stout AU, Lynn MJ, Yen KG, Kruger SJ, Lambert SR, et al. Stereopsis results at 4.5 years of age in the Infant Aphakia Treatment Study. Am J Ophthalmol. 2015;159:64–70.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kruger SJ, DuBois L, Becker ER, Morrison D, Wilson L, Wilson ME Jr, et al. Cost of intraocular lens versus contact lens treatment after unilateral congenital cataract surgery in the Infant Aphakia Treatment Study at age 5 years. Ophthalmology. 2015;122:288–92.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nagamoto T, Oshika T, Fujikado T, Ishibashi T, Sato M, Kondo M, et al. Clinical characteristics of congenital and developmental cataract undergoing surgical treatment. Jpn J Ophthalmol. 2015;59:148–56.

    Article  PubMed  Google Scholar 

  11. Nagamoto T, Oshika T, Fujikado T, Ishibashi T, Sato M, Kondo M, et al. A survey of the surgical treatment of congenital and developmental cataracts in Japan. Jpn J Ophthalmol. 2015;59:203–8.

    Article  PubMed  Google Scholar 

  12. Infant Aphakia Treatment Study Group, Lambert SR, Buckley EG, Drews-Botsch C, DuBois L, Hartmann EE, et al. A randomized clinical trial comparing contact lens with intraocular lens correction of monocular aphakia during infancy: grating acuity and adverse events at age 1 year. Arch Ophthalmol. 2010;128:810–8.

    Article  Google Scholar 

  13. Lundvall A, Zetterström C. Primary intraocular lens implantation in infants: complications and visual results. J Cataract Refract Surg. 2006;32:1672–7.

    Article  PubMed  Google Scholar 

  14. Faramarzi A, Javadi MA. Comparison of 2 techniques of intraocular lens implantation in pediatric cataract surgery. J Cataract Refract Surg. 2009;35:1040–5.

    Article  PubMed  Google Scholar 

  15. Chak M, Rahi JS, British Congenital Cataract Interest Group. Incidence of and factors associated with glaucoma after surgery for congenital cataract: findings from the British Congenital Cataract Study. Ophthalmology. 2008;115:1013–8.

    Article  PubMed  Google Scholar 

  16. Mills MD, Robb RM. Glaucoma following childhood cataract surgery. J Pediatr Ophthalmol Strabismus. 1994;31:355–60.

    CAS  PubMed  Google Scholar 

  17. Parks MM, Johnson DA, Reed GW. Long-term visual results and complications in children with aphakia: a function of cataract type. Ophthalmology. 1993;100:826–40.

    Article  CAS  PubMed  Google Scholar 

  18. Walton DS. Pediatric aphakic glaucoma: a study of 65 patients. Trans Am Ophthalmol Soc. 1995;93:403–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Rabiah PK. Frequency and predictors of glaucoma after pediatric cataract surgery. Am J Ophthalmol. 2004;137:30–7.

    Article  PubMed  Google Scholar 

  20. Haargaard B, Ritz C, Oudin A, Wohlfahrt J, Thygesen J, Olsen T, et al. Risk of glaucoma after pediatric cataract surgery. Invest Ophthalmol Vis Sci. 2008;49:1791–6.

    Article  PubMed  Google Scholar 

  21. Trivedi RH, Wilson ME Jr, Golub RL. Incidence and risk factors for glaucoma after pediatric cataract surgery with and without intraocular lens implantation. J AAPOS. 2006;10:117–23.

    Article  PubMed  Google Scholar 

  22. Kuhli-Hattenbach C, Lüchtenberg M, Kohnen T, Hattenbach LO. Risk factors for complications after congenital cataract surgery without intraocular lens implantation in the first 18 months of life. Am J Ophthalmol. 2008;146:1–7.

    Article  PubMed  Google Scholar 

  23. Kirwan C, Lanigan B, O’Keefe M. Glaucoma in aphakic and pseudophakic eyes following surgery for congenital cataract in the first year of life. Acta Ophthalmol. 2010;88:53–9.

    Article  PubMed  Google Scholar 

  24. Robb RM, Petersen RA. Outcome of treatment for bilateral congenital cataracts. Ophthalmic Surg. 1992;23:650–6.

    CAS  PubMed  Google Scholar 

  25. Wallace DK, Plager DA. Corneal diameter in childhood aphakic glaucoma. J Pediatr Ophthalmol Strabismus. 1996;33:230–4.

    CAS  PubMed  Google Scholar 

  26. Magnusson G, Abrahamsson M, Sjöstrand J. Glaucoma following congenital cataract surgery: an 18-year longitudinal follow-up. Acta Ophthalmol Scand. 2000;78:65–70.

    Article  CAS  PubMed  Google Scholar 

  27. Vasavada VA, Dixit NV, Ravat FA, Praveen MR, Shah SK, Vasavada V, et al. Intraoperative performance and postoperative outcomes of cataract surgery in infant eyes with microphthalmos. J Cataract Refract Surg. 2009;35:519–28.

    Article  PubMed  Google Scholar 

  28. Asrani S, Freedman S, Hasselblad V, Buckley EG, Egbert J, Dahan E, et al. Does primary intraocular lens implantation prevent “aphakic” glaucoma in children? J AAPOS. 2000;4:33–9.

    Article  CAS  PubMed  Google Scholar 

  29. Urban B, Bakunowicz-Łazarczyk A. Aphakic glaucoma after congenital cataract surgery with and without intraocular lens implantation. Klin Oczna. 2010;112:105–7.

    PubMed  Google Scholar 

  30. Astle WF, Alewenah O, Ingram AD, Paszuk A. Surgical outcomes of primary foldable intraocular lens implantation in children: understanding posterior opacification and the absence of glaucoma. J Cataract Refract Surg. 2009;35:1216–22.

    Article  PubMed  Google Scholar 

  31. Vasavada AR, Praveen MR, Tassignon MJ, Shah SK, Vasavada VA, Vasavada VA, et al. Posterior capsule management in congenital cataract surgery. J Cataract Refract Surg. 2011;37:173–93.

    Article  PubMed  Google Scholar 

  32. Lu Y, Ji YH, Luo Y, Jiang YX, Wang M, Chen X. Visual results and complications of primary intraocular lens implantation in infants aged 6 to 12 months. Graefes Arch Clin Exp Ophthalmol. 2010;248:681–6.

    Article  PubMed  Google Scholar 

  33. Lambert SR, Buckley EG, Plager DA, Medow NB, Wilson ME. Unilateral intraocular lens implantation during the first six months of life. J AAPOS. 1999;3:344–9.

    Article  CAS  PubMed  Google Scholar 

  34. Plager DA, Lynn MJ, Buckley EG, Wilson ME, Lambert SR, Infant Aphakia Treatment Study Group. Complications, adverse events, and additional intraocular surgery 1 year after cataract surgery in the Infant Aphakia Treatment Study. Ophthalmology. 2011;118:2330–4.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Teller DY. Measurement of visual acuity in human and monkey infants: the interface between laboratory and clinic. Behav Brain Res. 1983;10:15–23.

    Article  CAS  PubMed  Google Scholar 

  36. Birch EE, Cheng C, Stager DR Jr, Felius J. Visual acuity development after the implantation of unilateral intraocular lenses in infants and young children. J AAPOS. 2005;9:527–32.

    Article  PubMed  Google Scholar 

  37. Hiles DA. Visual acuities of monocular IOL and non-IOL aphakic children. Ophthalmology. 1980;87:1296–300.

    Article  CAS  PubMed  Google Scholar 

  38. Casaer P, Casteels I, Foets B. Surgical treatment outcomes of congenital and juvenile cataracts. Bull Soc Belge Ophtalmol. 2005;297:45–57.

    PubMed  Google Scholar 

  39. Autrata R, Rehurek J, Vodicková K. Visual results after primary intraocular lens implantation or contact lens correction for aphakia in the first year of age. Ophthalmologica. 2005;219:72–9.

    Article  PubMed  Google Scholar 

  40. Magli A, Forte R, Rombetto L. Long-term outcome of primary versus secondary intraocular lens implantation after simultaneous removal of bilateral congenital cataract. Graefes Arch Clin Exp Ophthalmol. 2013;251:309–14.

    Article  PubMed  Google Scholar 

  41. Lambert SR, Buckley EG, Drews-Botsch C, Infant Aphakia Treatment Study Group, et al. The Infant Aphakia Treatment Study: design and clinical measures at enrollment. Arch Ophthalmol. 2010;128:21–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by a Health and Labour Sciences Research Grant, Research on Measures for Intractable Diseases, from the Ministry of Health, Labour and Welfare of Japan. We thank all of the physicians from the following institutions who contributed to this study by providing valuable information: National Center for Child Health and Development, Hyogo Prefectural Kobe Children’s Hospital, Aichi Children’s Health and Medical Center, Osaka City General Hospital, Kyorin University School of Medicine, Fukushima Medical University, Osaka Medical Center and Research Institute for Maternal and Child Health, Iwate Medical University, University of Tsukuba Faculty of Medicine, Dokkyo Medical University, Kagoshima University Faculty of Medicine, Kanagawa Children’s Medical Center, Hamamatsu University School of Medicine, Osaka University Medical School, Keio University School of Medicine, Kurume University School of Medicine, Wakayama Medical University, Kagawa University Faculty of Medicine, Kanazawa University School of Medicine, University of Fukui Faculty of Medical Science, Shiga University of Medical Science, Ehime University School of Medicine, Toho University Omori Medical Center, Shinshu University School of Medicine, Kyushu University School of Medicine, Kobe University School of Medicine, Nagoya University School of Medicine, Hokkaido Children’s Hospital and Medical Center, and Kagawa National Children’s Hospital.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan

    Toshiyuki Nagamoto

  2. Nagamoto Eye Clinic, Tokyo, Japan

    Toshiyuki Nagamoto

  3. Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan

    Tetsuro Oshika

  4. Department of Applied Visual Science, Osaka University Graduate School of Medicine, Suita, Japan

    Takashi Fujikado

  5. Department of Ophthalmology, Kyushu University, Graduate School of Medicine, Fukuoka, Japan

    Tatsuro Ishibashi

  6. Department of Ophthalmology, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Miho Sato

  7. Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan

    Mineo Kondo

  8. Department of Ophthalmology, Iwate Medical University, Morioka, Japan

    Daijiro Kurosaka

  9. Department of Ophthalmology and Cell Biology, National Center for Child Health and Development, Tokyo, Japan

    Noriyuki Azuma

Authors
  1. Toshiyuki Nagamoto
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  2. Tetsuro Oshika
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  5. Miho Sato
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Corresponding author

Correspondence to Tetsuro Oshika.

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Conflicts of interest

T. Nagamoto, None; T. Oshika, None; T. Fujikado, None; T. Ishibashi, None; M. Sato, None; M. Kondo, None; D. Kurosaka, None; N. Azuma, None.

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Nagamoto, T., Oshika, T., Fujikado, T. et al. Surgical outcomes of congenital and developmental cataracts in Japan. Jpn J Ophthalmol 60, 127–134 (2016). https://doi.org/10.1007/s10384-016-0436-2

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  • DOI: https://doi.org/10.1007/s10384-016-0436-2

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