Outcome of early surgery for bilateral congenital cataracts in eyes with microcornea.

PURPOSE: To report the outcome of early surgery for bilateral congenital cataracts in eyes with microcornea.

DESIGN

Interventional case series.

METHODS

We retrospectively reviewed 22 eyes of 11 patients with microcorneas who underwent early surgery for bilateral congenital cataracts. All patients underwent lensectomy and anterior vitrectomy via the limbal approach by 12 weeks of age. The corneal diameters at the time of surgery ranged from 7.0 to 9.0 mm. The mean age at the time of surgery was 7.7 +/- 3.3 weeks (range, two to 12 weeks); the follow-up period was 115 +/- 58 months (range, 40 to 199 months). Aphakic eyes were corrected with spectacles or contact lenses. Visual acuities and the postoperative complications were evaluated periodically.

RESULTS

The morphologic types of cataract were nuclear (12 eyes), complete (eight eyes), and membranous (two eyes). Other preoperative ocular abnormalities included iris hypoplasia in 10 eyes and persistent fetal vasculature in three eyes. Systemic abnormalities were found in four patients. Postoperative complications occurred in 11 eyes (50%), including glaucoma (nine eyes), exudative retinal detachment (two eyes), rhegmatogenous retinal detachment, and secondary membrane formation, in one eye each. The binocular visual acuity was 20/40 to 20/20 in six patients (55%), 20/200 to 20/100 in two patients (18%), and 2/100 or worse in three patients (27%) who developed postoperative glaucoma.

CONCLUSION

Despite microcorneas, favorable visual outcomes were achieved after early surgery in this series. However, adequate management of postoperative complications, especially glaucoma, is required.