Abstract
Purpose
The objective of this study was to investigate preoperative factors associated with postoperative visual acuity outcomes and to develop a model to predict visual acuity prognosis.
Methods
A retrospective study was conducted by reviewing clinical charts of pediatric patients who underwent bilateral cataract surgery by a single surgeon (MEW) at the Storm Eye Institute. A multiple logistic regression model was constructed to predict the odds of poor postoperative visual acuity, that is, worse than 20/40, based on age at surgery, gender, primary intraocular lens (IOL) placement, ethnicity, and preoperative nystagmus.
Results
A sample size of 157 children (314 eyes) was investigated with median duration of follow-up of 6.4 years. A total of 78% of children with bilateral cataract had postoperative visual acuity of 20/40 or better. The presence of preoperative nystagmus was highly correlated with poor postoperative visual acuity (OR=6.0; 95% CLs, 2.5–14.1; P-value<0.0001). Children of age <1 year at time of cataract extraction (OR=3.2; 95% CLs, 1.4–7.6; P-value=0.0073), male gender (OR=2.3; 95% CLs, 1.1–4.5; P-value=0.02), the absence of primary IOL placement (OR=3.0; 95% CLs, 1.05–8.4; P-value=0.04), and non-Caucasian ethnicity (OR=2.0; 95% CLs, 1.02–4.03; P-value 0.0447) were associated with poor visual acuity postoperatively.
Conclusions
Satisfactory visual outcomes occurred in 78% of children operated on for bilateral cataracts. Preoperative nystagmus, age <1 year at time of cataract extraction, absence of primary IOL placement, male gender, and non-Caucasian ethnicity, were all factors associated with poor postoperative visual acuity.
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Acknowledgements
Supported in part by Research to Prevent Blindness, New York, NY, USA (to RHT and MEW).
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Bonaparte, L., Trivedi, R., Ramakrishnan, V. et al. Visual acuity and its predictors after surgery for bilateral cataracts in children. Eye 30, 1229–1233 (2016). https://doi.org/10.1038/eye.2016.166
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DOI: https://doi.org/10.1038/eye.2016.166
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