Incidence and risk factors of cataract following pediatric pars plana vitrectomy

Abstract Purpose To evaluate the incidence and risk factors for cataract following pediatric pars plana vitrectomy (PPV). Setting Tertiary referral center. Design Retrospective consecutive case series. Methods We included 242 eyes of 218 patients (< 18 years) that underwent lens-sparring PPV with a minimum follow-up of 6 months. Information regarding demographic and ophthalmic features, surgical history and procedures were gathered and analyzed. Eyes were evaluated for the development of cataract requiring surgery. Results Mean age at surgery was 6.8 ± 5.0 years and mean follow-up was 31.9 ± 37.5 months. After a mean interval of 17.0 ± 22.0 months, 80 eyes (33.1%) required lensectomy with posterior subcapsular cataract being the most common cataract type (76.3%). Overall, the risk of developing cataract after PPV increased from 21% at 1 year to 47% at 5 years The factor associated with the development of postoperative cataract were the need for multiple surgeries (58.8% vs. 13.6%, p < 0.001), the type of tamponade used p < 0.001), older age at surgery (101.9 ± 53.1 months vs. 71.0 ± 60.8 months, p < 0.001), and retinal detachment (78.8% vs. 19.1%, p < 0.001). Multivariate analysis including the aforementioned variables identified the need for multiple surgeries OR: 2.7 (CI: 1.2–6.2), p = 0.02) as a risk factor for the development post-PPV cataract while the use of air or no tamponade as protective ( p = 0.001). Conclusions Post-PPV cataract is a common complication occurring in about one-third of children. Risk factors include silicone oil tamponade, gas tamponade and multiple surgeries. Follow-up should be started early and continued for an extended duration after PPV especially in young children at risk of developing amblyopia.