Objective: To evaluate the relationship between preoperative nystagmus and visual outcome of congenital cataract surgery.
Methods: Retrospective review of 81 patients (84 eyes) who underwent surgery for cataract was conducted,in which 7 cases of unilateral cataract and 3 of bilateral cataract were associated with preoperative nystagmus. All patients lacked other structural ocular defects or neurologic abnormalities and were old enough to cooperate with recognition visual acuity testing. Outcome parameters studied were best-corrected postoperative visual acuity of the eyes.
Results: Best corrected postoperative visual acuity of the nystagmus eyes was 0.05 or worse in 3 (23%, 3/13), between 0.05 and 0.3 in 9 (69%, 9/13), and 0.3 or better in 1 (8%, 1/13). Best corrected visual acuity of the eyes without nystagmus was 0.05 or worse in 6 (8%), between 0.05 and 0.3 in 24 (34%), and 0.3 or better in 41 (58%) h. There was a statistical significance of preoperative visual acuity compared to postoperative visual acuity in cataract with (P= 0.04) or without nystagmus. The great statistical significance was shown in the improvement of visual acuity between the patients with nystagmus and without nystagmus.
Conclusion: Preoperative nystagmus in children with cataract does not preclude visual improvement, but may predict a poorer visual acuity outcome after cataract surgery. In these patients a decision must be made as to whether or not surgical intervention for the cataract would be worthwhile at this stage.