Opere Edilmiş Olan Konjenital/İnfantil Katarakt Hastalarında Klinik Özellikler, Zaman İçerisinde Oküler Parametrelerin Değişimi, Oküler Erken ve Geç Dönem Komplikasyonlarının Gelişmesinde Klinik Risk Faktörlerinin Belirlenmesi

Abstract

The aim of this study was to determine the change of ocular parameters, early and late complications, their relationship with clinical features and preoperative risk factors in unilateral/bilateral congenital/infantile cataracts. Patients aged 0-3 years who underwent surgery for unilateral/bilateral congenital/infantile cataracts were included in the study. Demographic characteristics, systemic screening results, preoperative and postoperative ophthalmologic examination findings, ocular biometry characteristics, early and late postoperative complications and additional surgeries were recorded. In this study 58 eyes of 34 patients, 18 girls and 16 boys were included. Twenty-four patients underwent bilateral and 10 patients underwent unilateral cataract surgery. The mean age at surgery was 12.0±12.2 (1.7-35.6) and the mean follow-up was 52.0±24.4 months. Postoperatively, the most common complication was posterior synechia in 9 eyes (15.6%), followed by capsular phimosis in 8 eyes (13.8%). The most common late complication was capsular phimosis in 10 eyes (17.2%), followed by visual axis opacification in 6 eyes (10.3%). The rate of additional surgery was 27%, and the most common cause was a capsullectomy procedure for capsular phimosis at a rate of 13.6%. The mean preoperative axial length was 18.6±2.4 mm; postoperative 21.1±1.3 mm (p<0.05). Aphakic glaucoma developed in six patients (17.6%) with an average of 40.9±34.2 (1.1-84.7) months. The risk factors for aphakic glaucoma were family history of congenital cataract, postoperative anterior synechia, capsular phimosis and short preoperative axial length (p=0.010, p=0.014, p=0.025 and p=0.005 respectively). The best corrected visual acuity in 33 eyes where visual acuity can be evaluated at the last follow-up is 0.11±0.16 (0.1-0.9) in 7 eyes in the unilateral group, and 0.41±0.24 (0.01-0.04) in 24 eyes in the bilateral group. Congenital cataract requires early diagnosis and treatment because of the risk of visual loss. Aphakic glaucoma is one of the most serious complications seen after surgery and since it may develop early and late postoperatively, close and lifelong follow-up is required in all patients, especially in patients with risk factors.