Objective: To evaluate the long-term visual outcome and complications after bilateral congenital cataract surgery performed prior to 12 months of age.
Methods: A prospective case study. 31 cases (62 eyes) of bilateral congenital cataract were included.All patients received bilateral cataract extraction combined with primary capsulotomy and anterior vitrectomy simultaneously.After the operation, all patients wore aphakic glasses during the follow-up period.The unilateral and bilateral visual acuities (VA) at the last visit were determined and post-operative complications were evaluated, and the relationship between bilateral VA and the length of the follow-up period was also analyzed.
Results: The median age at surgery was 3.0 M (0.5 to 11 M) , the median follow-up period was 4.0 years (3.0 to 8.5 years). 37 out of 62 eyes (59.68%) achieved unilateral best corrected visual acuity equal or better than 0.3. 27 among 31 cases (87.1%) achieved binocular best corrected visual acuity equal or better than 0.3.Binocular best corrected visual acuity improved with the increase in the follow-up period and the patients' age (R(2) = 0.135,P = 0.0024) .Post-operative complications included strabismus (7 cases, 22.58%), nystagmus (13 cases, 41.94%), optical opacity (3 cases, 9.68%), ocular hypertension (1 cases, 3.23%).
Conclusions: Surgery for congenital cataracts performed prior to 12 months of age is safe, and most of the subjects can achieve functional vision acuity. As these children age, the bilateral best corrected visual acuity can still keep improving.