VISUAL OUTCOME AFTER PEDIATRIC CATARACT-SURGERY - IS AGE A MAJOR FACTOR

Aims-To determine functional results after unilateral and bilateral ca taract surgery in children with different aphakic optical correction. Methods-In this retrospective study, we evaluated visual acuity and bi nocular vision in 107 children who underwent cataract surgery during t he 10 year period from 1985 to 1995. Aphakia was corrected by an intra capsular intraocular lens (IOL), spectacles or contact lenses. Results -Mean visual acuity was >20/40 (<0.3 log MAR) with normal binocular vi sion in 58 children over 7 months of age operated on for bilateral cat aracts. Pseudophakic eyes regained visual acuity >20/63 (<0.5 log MAR) more often (90%) than aphakic eyes (46%) (p<0.001). Binocular vision was also achieved more often after IOL implantation (p<0.001). Visual outcome of early bilateral cataracts was less satisfactory in children with abnormal foveolar function. For 49 children who had surgery for unilateral cataracts, prognosis was poor when surgery was performed be fore the age of 7 months. For cataract surgery in older children (grea ter than or equal to 7 months) mean visual acuities were better with I OL implantation (p<0.05). Conclusion-Cataract surgery with unilateral and bilateral IOL implantation can provide a beneficial effect on fina l visual outcome in children who are operated on before abnormal foveo lar function develops.