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The impact of late-treated pediatric cataract on intraocular pressure

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Abstract

Purpose

To assess the intraocular pressure and visual acuity before and after pediatric congenital cataract surgery performed at a relatively older age.

Methods

A retrospective analysis of all consecutive pediatric patients diagnosed and operated for bilateral congenital cataracts during a seven-year period (2012–2018) in rural southern Ethiopia. Non-ambulatory vision was defined as hand motion or worse. The main outcome measures were intraocular pressure (IOP) and visual acuity.

Results

Thirty-two children were included, 17 females (53.1%), with a mean age of 11 years (± 2.83) [range, 7–18]. A total of 59 eyes were operated on. The mean follow-up was 4.8 ± 1.8 years (range, 2–8). VA improved from 20/1400 preoperatively to 20/440 postoperatively OD and 20/540 OS (p < 0.001). More eyes had ambulatory vision after cataract surgery than pre-surgery (56 eyes [95%] vs. 29 eyes [49%], p < 0.001). The IOP decreased from a mean preoperative value of 18.4 ± 7.1 mmHg to 14.5 ± 2.9 postoperatively OD (p < 0.001) and 16.3 ± 5.9 mmHg to 13.9 ± 3.5 OS (p < 0.001). Fifteen eyes (24%) had increased IOP (> 21 mmHg) preoperatively, of which three remained high after surgery. Positive correlations were found between IOP, axial length and cup-to-disc ratio. None of the patients required pressure-lowering procedures.

Conclusion

Bilateral congenital cataracts may be associated with ocular hypertension, with possible progression to glaucoma if left untreated. Surgery at a relatively older age often was associated with a significant improvement in intraocular pressure and ambulatory vision.

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Acknowledgements

We would like to thank Dr. Demoze Arega, Department of Ophthalmology, Hawassa Referral hospital, Ethiopia, for his help in the case management and procedures, and Prof. Ehud Zohary, Edmond and Lilly Safra Brain Institute, Hebrew University Jerusalem, for his thorough review and thoughtful comments.

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Authors and Affiliations

  1. Ophthalmology Department, Padeh Medical Center, Poriya, Israel, affiliated With Bar-Ilan Faculty of Medicine, Safed, Israel

    Itay Ben-Zion

  2. Goldschleger Eye Institute, Faculty of Medicine, Sheba Medical Center, Tel Hashomer, Israel, affiliated With Sackler, Tel Aviv University, Tel Aviv, Israel

    Daphna Prat

  3. Division of Ophthalmology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Daphna Prat

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  1. Itay Ben-Zion
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Correspondence to Itay Ben-Zion.

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This study adheres to the Declaration of Helsinki and was approved by the regional institutional ethics review board (IRB) of the Hebrew University in Jerusalem and Hawassa University, Ethiopia.

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Informed consent was obtained from all participants.

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Ben-Zion, I., Prat, D. The impact of late-treated pediatric cataract on intraocular pressure. Int Ophthalmol 41, 1531–1539 (2021). https://doi.org/10.1007/s10792-021-01727-y

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