Results of congenital cataract surgery with and without intraocular lens implantation in infants and children

Background: Operations for congenital cataract in children in the past had resulted in aphakia. Improvement in surgical tools and techniques as well as in intraocular lens (IOL) implantation has led to correction of the aphakia by IOL implantation. We report the outcome of cataract surgery with and without IOL on these children in our institution between 1991-2008. Methods: In this retrospective cohort study, the medical records of all children who underwent surgery for congenital cataract were reviewed. The final study group included 144 children (218 eyes). Postoperative visual acuity (VA) was tested either by Teller Acuity Cards (in preverbal children) or by the Snellen chart. Data on VA status and postoperative complications were retrieved. Results: Patients with bilateral cataract had better postoperative VA than patients with unilateral cataract (logMAR 0.559∈±∈0.455 vs. 0.919∈±∈0. 685, respectively, P∈<∈0.001). Children who underwent IOL implantation had better postoperative VA than those who did not, but the type of surgery had no significant effect after correction for the child's age at surgery (P∈=∈0.346). Secondary cataract occurred more frequently in the extra-capsular cataract extraction (ECCE)∈+∈IOL implantation group than in the ECCE only group (20.6 % vs. 8.3 %, respectively, P∈=∈0.018). Conclusions: Patients with bilateral cataract had better postoperative VA compared with those with unilateral cataract. The type of surgery had no effect on final VA, but there was a higher rate of secondary cataract in the ECCE + IOL patients compared to the ECCE only patients.