The Risk Factors Of Low Vision In Children After Cataract Surgery

[Purpose] To investigate the impact of pediatric cataract on the development of vision and to determine the risk factors for the formation of low vision in children after cataract surgery.[Methods] Retrospective study of 151 eyes from 92 children with cataract after pediatric cataract surgery. Among them, 78cases were identified as congenital cataract and 14 cases as traumatic cataract.97 eyes were complicated with other congen-ital abnormality. Primary intraocular lens (IOL) implantation was applied in 88 eyes while 28 eyes were employed with secon-dary IOL, and 35 aphasic eyes remained uncorrected. Meanwhile,the age of onset, unilateral or bilateral eyes, severity of opacities, duration before cataract surgery,types of operation,refractive condition and postoperative complications were inv-estigated. Thereafter, a Person's test and a logistic regres-sion with multiple factor analysis were employed. The identif-ication of low vision was made based on the criteria from WHO (1973).[Results] The mean follow-up period is 3.2±1.2 years. The mean duration before operation is 5.5±1.2 years. The incid-ence of low vision: congenital cataract 55.46%, traumatic ca-taract 25%,congenital cataract with other ocular abnormality59.25%.Unilateral cataract 78.95% and 52% in both eyes. Eyeswith primary IOL implantation 43.18% and 42.8% with secondary IOL implantation. Eyes with refraction correction 42.71% andeyes without refraction correction 82.86%. Postoperative co-mplications occurred in 59.26% eyes. Multivariate Logistic regression analysis, Odds ratio (OR),95% confidence interval (CI) and P value were: congenital cataract(OR, 7.70; 95% CI,3.55～31.03; P = .002) ,age atsurgery≥3 years(OR, 14.81; 95% CI,6.91～22.85; P=.001),with nystagmus (OR, 9.13; 95% CI,2.62～52.88; P = .000) and the absence of postoperative ref-raction correction (OR, 5.56; 95% CI,1.32～16.94; P = .000)respectively.[Conclusions] Congenital cataract, age at operation,nystagmus and the absence of postoperative refraction correction were the main risk factors for the low vision in children cataract after pediatric cataract surgery. The early age onset, late treatment, unilateral cataract and after cataract were the other risk factors. Better vision is found in dilateral cataract than that in uinlateral. The patients with traumatic cataract had better corrected vision after pediatric cataract surgery than those with congenital cataract.