FUNCTIONAL OUTCOME AFTER SURGICAL-TREATME NT IN INFANTS CATARACTS - AREVIEW OF 135 CASES

Purpose Visual outcome after cataract surgery in children. Methods The authors studied the functional results (visual acuity and binocular v ision) of 135 children operated for unilateral or bilateral cataracts during the 9-year period 1985-1994. Aphakia was corrected by an implan t within the capsular bag, spectacles or contact lenses. Results For b ilateral cataracts, (68 patients), mean visual acuity > 20/40 and norm al binocular vision are found together in cases of late appearance ope rated after 7 months of age. Pseudophakic eyes regained visual acuity greater than 20/40 more often than non-implanted eyes, with a statisti cally significant differences (P < 0.001). Binocular vision was also o btained more often in children after implantation (P < 0.05). The func tional results of operations on early cataracts treated before the age of 8 months were not as good because of abnormal development of the f oveolar function. For unilateral cataracts (67 patients), the prognosi s was poor when operated before the age of 8 months. Visual acuity rar ely exceeded 20/200 however the aphakia was corrected. Prognosis was b etter for partial cataracts and late-appearing cataracts. Implantation appeared to be of more benefit, with a statistically significant diff erence (P < 0.05) for visual acuity greater than 20/40 in children rec eiving an implant. Conclusion Regained binocular vision and absence of amblyopia depend on the quality of previous visual experience adn abs ence of post-operative strabismus. Implantation appears beneficial for final visual results.