The Analysis Of The Factors Associated With Low Vision After The Surgury Of Congenital Cataract

Objective To report the incidence of the low vision after the surgury of congenital cataract and the analysis of the factors associated with low vision.Methods All children aged less than 12 years old,who had diagnosed congenital cataract and undergone cataract surgury in our hospital,the best corrected visual acuty lasting at least 1 year.Register the type of the cataract,age at the surgury,the complication of the eyes before and after the suegury.Retrospective analysis of the incidence of the low vision after the surgury of congenital cataract and the correlation analysis of the factors associated with low vision.Results 113 patients(226 eyes) of bilateral congenital cataract and 83 patients of unilateral cataract were included.The incidence of the low vision in bilateral was 29.2% (66/226);The incidence of the low vision in unilateral congenital cataract cases is 74.7%(62/83),there was significant diference between the incidence of the low vision after the surgury in uninlateral and the bilateral cases(χ~2=51.783,P=0.000).Cataract type, time since presentaton,age at surgery,presence of strabismus and nystagrnus,secondary glaucoma were significant for the low vision of bilateral cases(P＜0.01);the time since presentaton and presence of strabismus were significantly in low vision of unilateral cases(P＜0.01).The incidence of PCO is 9.1%(28/309),3 cases developed into irreversibility amblyopia;the incidence of secondary glaucoma is 5.2%(18/309),2 eyes were pupillary block glaucoma,14 eyes were developed after the IOL implantation of the aphakia.The multivariate logistic regression shows that the unilateral cataract,nystagrnus and strabilismus are the factors most strongly associated with the low vision,the relative odds were 251.922,52.366,11.649;the odds of low vision were increased with each stage of the time since presentaton among 3～5 years,5～8 years,8～12 years,the relative odds are 18.188,63.962,21.786.Conclusion The unilateral cataract is the magor factor most strongly associated with the low vision after the surgury of congenital cataract;nystagrnus and strabilismus were the two high risk of low vision after the surgury of congenital cataract,the criticality is early discovery and early operation to re-establish the visual passageway,the amblyopia training could help the covery of the visual function;Poster capsular opacification and secondary glaucoma are the the most frequently complication after the operation,it is very important for the further consultation after the surgury.