Long-term outcomes of congenital cataract surgery in eyes with microcornea operated within the first year of life.

We retrospectively evaluated the long-term surgical outcomes of congenital cataract in eyes with microcornea, including both aphakic and pseudophakic eyes. A total of 43 eyes from 25 patients who underwent cataract surgery within the first 12 months of life (mean age at surgery: 3.3 ± 2.4 months) were analyzed, with a mean follow-up period of 13.7 ± 2.4 years (range: 10-18 years). The mean corneal diameter was 8.8 ± 0.8 mm. The cohort included 14 cases with bilateral aphakia, 4 cases with bilateral pseudophakia, 4 cases with unilateral aphakia, and 3 cases with unilateral pseudophakia. The mean corrected distance visual acuity (CDVA) at the final visit was 0.543 ± 0.709 logMAR. CDVA of 20/40 or better was achieved in 39% of bilateral aphakic eyes, 88% of bilateral pseudophakic eyes, 50% of unilateral aphakic eyes, and 33% of unilateral pseudophakic eyes. The bilateral pseudophakia group demonstrated significantly better CDVA compared to the bilateral aphakia group (p = 0.010). Secondary glaucoma developed in 18.8% of aphakic eyes and 0% of pseudophakic eyes (p = 0.149). Visual axis opacification occurred in 12.5% of aphakic eyes and 54.5% of pseudophakic eyes (p = 0.010). Surgical treatment of congenital cataract in eyes with microcornea resulted in satisfactory long-term outcomes. Secondary glaucoma in aphakic eyes and visual axis opacification in pseudophakic eyes remain important considerations in long-term management.