[Late complications and functional results at least 5 years following pars plana lentectomy for congenital cataract].

Pars plana or pars plicata lentectomy was introduced for congenital cataract at the University Eye Clinic of Freiburg 12 years ago. Records of 32 patients (48 eyes) who were operated on during a period of 7 years were retrospectively analyzed to determine the anatomical and functional results in comparison to previous methods of treatment for congenital cataract. The documented follow-up was at least 5 years long (maximum 11 years, mean 7.3 years). Seventeen patients had bilateral, 15 patients monolateral cataract operations. Thirteen eyes were operated on during the first 2 months of life, and 31 of the 48 eyes during the first year. Sixteen of the 48 eyes had additional malformations, like microphthalmus, different stages of persistent hyperplastic primary vitreous, or anterior chamber malformation. Visual acuity was at least 20/50 at the last visit in 3 of 15 eyes after monolateral lentectomy and in 19/33 eyes after bilateral lentectomy. Twenty-four children are now able to attend a regular school; only one child is attending a school for the visual handicapped; another child attends a school for deaf children. Postoperatively, secondary cataract or a retropupillary membrane was found in two eyes. Glaucoma developed in two eyes, requiring additional surgery. Postoperative retinal detachment caused by a giant tear complicated the postoperative course in one case. The anatomic results turned out to be better than after discission and aspiration with fewer postoperative complications like secondary cataract, glaucoma, or retinal detachment. The functional outcome is mainly dependent on good postoperative orthoptic and pleoptic management of the children.