Session Title: Free Paper Session 5: Anterior/Posterior Segment Surgery
Session Date/Time: Thursday 07/09/2017 | 11:00-12:30
Paper Time: 11:12
Venue: Room 117
First Author: : R.Raman INDIA
Co Author(s): : S. Agarkar V. Gokhale M. Bhende M. Jain T. Sharma
To report the incidence, estimate the long-term risk and predisposing factors for retinal detachment (RD) after paediatric cataract surgery and report their surgical outcomes.
481 eyes of 295 children aged below 16 years of age with no other ocular and systemic anomalies who underwent lensectomy, posterior capsulorhexis and anterior vitrectomy combined with primary IOL implantation during the study period of 1996 to 2007 at a tertiary eye care institute were included.
Kaplan-Meier survival estimates and Cox proportional hazard regression model for estimating cumulative risk and hazard ratio, respectively. Difference between measured pre-operative axial length and age-matched mean axial length (noted from prior studies) was calculated, axial length difference (ALD; minus and plus denotes myopia and hypermetropia,respectively).
Of the total, 12 eyes of 9 children developed RD with a median time of 70 months after cataract surgery. The overall 10 years risk of RD was 5.5% after cataract surgery. All nine children were male. The multi-adjusted hazard ratio (HR) associated with increased risk of RD was 12.42 (95% confidence interval (CI), 2.91-53.01; p= 0.001) for eyes of children with mental retardation and 21.93 (95% CI, 2.95-162.80; p=0.003) for eyes of children with ALD greater than 1mm (ALD < -1 mm, myopic) than the age adjusted mean. Posterior vitreous detachment induced retinal break was the most common (8 eyes) cause of RD. No surgical intervention was done in 2 eyes. Scleral buckle and combined vitrectomy with belt buckle was done in 4 and 6 eyes, respectively. A final follow-up, 5 and 9 eyes had a visual acuity better than or equal to 6/18 and 6/60, respectively.
A 5.5 % risk is estimated for the first 10 years for RD after paediatric cataract surgery in children with no known ocular and systemic anomalies. The risk significantly increase in a child with 3 “M”: male, myopic, and mentally retardation. We emphasise the need for regular and long term follow-up after paediatric cataract surgery.