Surgical management of pediatric cataract and lens disorders: a consecutive surgical series from Southern Brazil

To describe the demographics, surgical management, and outcomes of pediatric patients undergoing eye surgery at a tertiary referral center in Southern Brazil, with particular emphasis on cataract and lens disorders. This retrospective consecutive case series included patients younger than 18 years who underwent ocular procedures under general anesthesia between January 2019 and December 2025 by a single surgeon. Patients were classified according to the primary indication for treatment, and analyses were performed for those undergoing cataract and lens-related surgery. A total of 249 pediatric patients underwent 365 procedures. Of these, 148 patients (214 eyes) underwent cataract and lens-related surgery and 101 underwent posterior segment interventions. The most common lens diagnoses were isolated congenital cataract (61.5%), developmental cataract (18.9%), persistent fetal vasculature (14.2%), and ectopia lentis/lens subluxation (5.4%). Follow-up information was available for 230 patients (92.4%), with a mean follow-up of 41.3 months. Within the lens surgery cohort, glaucoma developed in 12 patients (8.1%). Visual axis complications occurred in 10 patients (6.8%), intraocular lens–related complications in 4 (2.7%), and 15 patients (10.1%) required additional intraocular procedures. No postoperative retinal detachments or endophthalmitis occurred. Final best-corrected visual acuity of 20/40 or better was achieved in 27.5% of patients with isolated congenital cataract, 68.2% with developmental cataract, 11.8% with persistent fetal vasculature–associated cataract, and 87.5% with ectopia lentis/lens subluxation. Cataract and lens-related procedures accounted for a substantial proportion of pediatric surgeries and were associated with meaningful visual rehabilitation despite the inclusion of complex conditions. These findings provide real-world insight into the surgical management, complications, and outcomes of pediatric cataract and lens disorders. The study was approved by the Institutional Review Board of the Escola Paulista de Medicina, Federal University of São Paulo (CAAE 73540523.2.0000.5505; approval number 6.571.840).