Factors Affecting Visual Outcome Following Surgical Treatment of Cataracts in Children


Purpose: To assess treatment results in pediatric patients with cataracts, to evaluate the efficacy of various surgical interventions, and to determine the factors that affect visual outcomes. Methods: This is aProspective cohort study. We studied a consecutive series of pediatric patients with congenital, developing, or traumatic cataracts who underwent surgery between January, 1999 and April, 2012 at Drashti Netralaya, Dahod. Patient demographics, cataract type, presenting symptoms, surgical intervention, postoperative visual acuity, and follow-up refractive changes were recorded. Results: In total, 1305 eyes of 1047 children were included: unilateral cataracts were present in 786 (60.2%) eyes. There were 610 (46.7%) traumatic and 695 (53.3%) non-traumatic cases. Ages at surgery ranged from 1 to 215 months. Eyes were grouped by the surgical intervention performed: Group 1, pars plana approach including 366 (28%) eyes that underwent lensectomies, and Group 2, anterior approach, including 939 (71.9%) eyes that underwent phacoemulsification ± IOL placement or small incision cataract surgery ± IOL placement. The mean follow-up time was 117 days. Ultimately, 113 (30.9%) Group 1 and 503 (53.6%) Group 2 patients achieved a visual acuity better than 20/60 (P < 0.001). Age at intervention, laterality, sensory nystagmus, pretreatment vision, IOL insertion, and etiology were all significantly related (all P < 0.001) to visual outcome. Conclusions: Surgical treatment with intraocular lens implantation for children with congenital, developmental, or traumatic cataracts is an effective treatment for visual rehabilitation. Visual outcome was significantly better in cases of traumatic cataracts versus non-traumatic cataracts.

Share and Cite:

M. Shah, S. Shah, K. Shikhangi, P. Upadhyay and G. Bardoloi, "Factors Affecting Visual Outcome Following Surgical Treatment of Cataracts in Children," Open Journal of Ophthalmology, Vol. 2 No. 4, 2012, pp. 131-139. doi: 10.4236/ojoph.2012.24029.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] V. Long and S. Chen, “Surgical Interventions for Bilateral Congenital Cataract,” Cochrane Database of Systematic Reviews, Vol. 19, No. 3, 2006, p. CD003171.
[2] M. A. Zimmermann-Paiz and C. R. Quiroga-Reyes, “Pediatric Cataract in a Developing Country: Retrospective Review of 328 Cases,” Arquivos Brasileiros de Oftalmologia, Vol. 74, No. 3, 2011, pp. 163-165.
[3] P. Gogate and K. Kalua, “Blindness in Childhood in Developing Countries: Time for a Reassessment,” PLoS Medicine, Vol. 6, No. 12, 2009, p. e1000177. doi:10.1371/journal.pmed.1000177
[4] M. E. Wilson and S. K. Pandey, “Paediatric Cataract Blindness in the Developing World: Surgical Techniques and Intraocular Lenses in the New Millennium.” British Journal of Ophthalmology, Vol. 87, No. 1, 2003, pp. 14-19. doi:10.1136/bjo.87.1.14
[5] K. M. de Carvalho and N. Minguini, “Characteristics of a Pediatric Low-Vision Population,” Journal of Pediatric Ophthalmology and Strabismus, Vol. 35, No. 3, 1998, pp. 162-165.
[6] W. C. Owens and W. F. Hughes, “Results of Surgical Treatment of Congenital Cataract,” Archives of Ophthalmology, Vol. 39, No. 3, 1948, pp. 339-350. doi:10.1001/archopht.1948.00900020346009
[7] G. Msukwa, M. Njuguna, et al., “Cataract in Children Attending Schools for the Blind and Resource Centers in Eastern Africa,” Ophthalmology, Vol. 116, No. 5, 2009, pp. 1009-1012. doi:10.1016/j.ophtha.2008.12.020
[8] R. Dandona and L. Dandona, “Review of Findings of the Andhra Pradesh Eye Disease Study: Policy Implications for Eye-Care Services,” Indian Journal of Ophthalmology, Vol. 49, No. 4, 2001, pp. 215-234.
[9] A. R. Vasavada, S. A. Vasavada, N. Bobrova, M. R. Praveen, S. K. Shah, V. A. Vasavada, A. J. V. Pardo and S. M. Raj, “Trivedi RH Outcomes of Pediatric Cataract Surgery in Anterior Persistent Fetal Vasculature. Journal of Cataract & Refractive Surgery, Vol. 38, No. 5, 2012, pp. 849-857. doi:10.1016/j.jcrs.2011.11.045
[10] R. M. Robb and R. A. Petersen, “Outcome of Treatment for Bilateral Congenital Cat-aracts,” Transactions of the American Ophthalmological Society, Vol. 90, 1992, pp. 183-194
[11] M. Yamamoto, M. Dogru, et al., “Visual Function Following Congenital Cataract Surgery,” Japanese Journal of Ophthalmology, Vol. 42, No. 5, 1998, pp. 411-416. doi:10.1016/S0021-5155(98)00039-2
[12] J. Francois, “Late Results of Congenital Cataract Surgery,” Ophthalmology, Vol. 86, No. 9, 1979; pp. 1586-1598.
[13] D. A. Hiles and P. H. Wallar, “Visual Results Following Infantile Cataract Surgery,” International Ophthalmology Clinics, Vol. 17, No. 4, 1977, pp. 265-282.
[14] H. G. Scheie, “Aspiration of Congenital or Soft Cataracts: A New Technique,” American Journal of Ophthalmology, Vol. 50, 1960, pp. 1048-1056.
[15] D. Taylor, “Choice of Surgical Technique in the Management of Congenital Cataract,” Transactions of Ophthalmological Societies of United Kingdom, Vol. 101, No. 1, 1981, pp. 114-117.
[16] M. M. Parks, “Posterior Lens Capsulectomy during Primary Cataract Surgery in Children,” Ophthalmology, Vol. 90, No. 4, 1983, pp. 344-345.
[17] G. L. Rogers, C. L. Tishler, B. H. Tsou, et al., “Visual Acuities in Infants with Congenital Cataracts Operated on Prior to 6 Months of Age,” Archives of Ophthalmology, Vol. 99, No. 6, 1981, pp. 999-1003. doi:10.1001/archopht.1981.03930010999002
[18] S. S. Gelbart, C. S. Hoyt, G. Jastrebski, et al., “Long- Term Visual Results in Bilateral Congenital Cataracts,” American Journal of Ophthalmology, Vol. 93, No. 5, 1982, pp. 615-621.
[19] D. Taylor, Vaegan, J. A. Morris, et al., “Amblyopia in Bilateral Infantile and Juvenile Cataract: Relationship to Timing of Treatment,” Transactions of Ophthalmological Societies of United Kingdom, Vol. 99, No. 1, 1979, pp. 170-175.
[20] R. H. Trivedi and M. E. Wilson, “Accuracy of the Holladay 2 Intraocular Lens Formula for Pediatric Eyes in the Absence of Preoperative Refraction,” Journal of Cataract & Refractive Surgery, Vol. 37, No. 7, 2011, pp. 1239-1243. doi:10.1016/j.jcrs.2011.01.021
[21] S. K. McClatchey, “Choosing IOL Power in Pediatric Cataract Surgery,” International Ophthalmology Clinics, Vol. 50, No. 4, 2010, pp. 115-123. doi:10.1097/IIO.0b013e3181f0f2e0
[22] N. G. Congdon and S. Ruiz, “Determinants of Pediatric Cataract Program Outcomes and Follow-Up in a Large Series in Mexico,” Journal of Cata-ract & Refractive Surgery, Vol. 33, No. 10, 2007, pp. 1775-1780. doi:10.1016/j.jcrs.2007.06.025
[23] M. L. Yang, C. H. Hou, et al., “Clinical Characteristics and Surgical Outcomes of Pediatric Cataract in Taiwan,” Graefe’s Archive for Clinical and Experimental Ophthalmology, Vol. 244, No. 11, 2006, pp. 1485-1490. doi:10.1007/s00417-006-0308-4
[24] H. Ahmadieh, M. A. Javadi, et al., “Primary Capsulectomy, Anterior Vitrectomy, Lensectomy, and Posterior Chamber Lens Implantation in Children: Limbal versus Pars Plana,” Journal of Cataract & Refractive Surgery, Vol. 25, No. 6, 1999, pp. 768-775. doi:10.1016/S0886-3350(99)00040-1
[25] D. Thouvenin, “Management of Infantile Cataracts: Surgical Technics and Choices in Lens Implantation,” Journal Francais D Ophtalmologie, Vol. 34, No. 3, 2007, pp. 198-202. doi:10.1016/j.jfo.2011.01.003
[26] K. S. Morgan and Z. A. Karcioglu, “Secondary Cataracts in Infants after Lensectomies,” Journal of Pediatric Ophthalmology and Strabismus, Vol. 24, No. 4 1987, pp. 45-48.
[27] D. Taylor, “Choice of Surgical Technique in the Management of Congenital Cataract,” Transactions of Ophthalmological Societies of United Kingdom, Vol. 101, No. 1, 1981, pp. 114-117.
[28] S. Basti and U. Ravishankar, “Results of a Prospective Evaluation of Three Methods of Management of Pediatric Cataracts,” Ophthalmology, Vol. 103, No. 5, 1996, pp. 713-720.
[29] S. A. Grossman and G. A. Peyman, “Long-term Visual Results after Pars Plicata Lensectomy-Vitrectomy for Congenital Cataracts,” British Journal of Ophthalmology, Vol. 72, No. 8, 1988, pp. 601-606. doi:10.1136/bjo.72.8.601
[30] J. J. Kanski and M. D. Crick, “Lensectomy,” Transactions of Ophthalmological Societies of United Kingdom, Vol. 97, No. 1, 1977, pp. 52-57.
[31] B. Gessner and S. Wiese, “Results of Pars Plana Lensectomy for Childhood Cataract,” Ophthalmologe, Vol. 101, No. 9, 2004, pp. 901-906.
[32] R. Khandekar and A. Sudhan, “Pediatric Cataract and Surgery Outcomes in Central India: A Hospital Based Study,” Indian Journal of Medical Sciences, Vol. 61, No. 1, 2007, pp. 15-20. doi:10.4103/0019-5359.29593
[33] P. Hochstrasser and B. Gloor, “Surgical Results of Uni- and Bilateral Congenital and Traumatic Cataract in Infancy to Adolescence,” Klin Monbl Augenheilkd, Vol. 204, No. 5, 1994, pp. 274-278. doi:10.1055/s-2008-1035534
[34] R. V. Keech and A. C. Tongue, “Complications after Surgery for Congenital and Infantile Cataracts,” American Journal of Ophthalmology, Vol. 108, No. 2, 1989, pp. 136- 141.
[35] M. A. Shah, S. M. Shah, S. B. Shah and U. Patel, “Effect of Interval between Time of Injury and Timing of Intervention on Final Visual Outcome in Cases of Traumatic Cataract,” European Journal of Ophthalmology, Vol. 21, No. 6, 2011, pp. 760-765. doi:10.5301/EJO.2011.6482

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.