Preoperative factors affecting visual outcome after unilateral cataract extraction in pediatric age group

PurposeThe aim was to analyze preoperative factors that result in a poor postoperative (PO)visual outcome in cases with unilateral cataract, mainly the relationship betweenpreoperative interocular axial length difference (IALD) and PO visual acuity.Materials and methodsA retrospective chart review of 200 pediatric patients with unilateral congenitalcataracts was carried out from 2011 to 2015. A total of 30 participants who hadcataract extraction with primary intraocular lens implantation were included, withthe performed surgical procedure at an age between 10 months and 11 years olderat the time of surgery. Statistical analysis was done.ResultsA total of 30 participants were included in this study who fulfilled all the inclusioncriteria and provided complete responses. Mean IALD was 1.37 mm. The meanIALD was 0.26mm solely in patients with good visual outcome, whereas childrenwho had a fair and poor outcome, the mean IALD was 1.87 and 2.24 mm,respectively (P=0.008). All the patients who had good visual outcome werecompliant with amblyopia therapy, whereas 60% of patients with the fair visualoutcome and 28.50% of those with poor visual outcome solely were compliant withamblyopia therapy (P=0.001). Mean age at the time of surgery was 39.40 months.Eleven patients had good vision, and 91.9% of them were younger than 2 years oldat the time of surgery (P=0.001).ConclusionThe smaller the preoperative IALD, the younger the surgical age, the earlier thesurgical intervention, and the higher the compliance with amblyopia therapy, thehigher is the PO visual acuity in a child with unilateral cataract.