Complications of pediatric cataract surgery and intraocular lens implantation

J Cataract Refract Surg. 1999 Dec;25(12):1585-8. doi: 10.1016/s0886-3350(99)00296-5.


Purpose: To study the pattern of postoperative complications following extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation in pediatric eyes.

Setting: Tertiary eye care center, New Delhi, India.

Methods: A retrospective analysis of 39 eyes of 28 children referred for complications after ECCE with IOL implantation was performed. The results evaluated were visual acuity, iridocapsular problems, and IOL-related complications. Additional interventions such as neodymium:YAG (Nd:YAG) capsulotomy, surgical membranectomy, and penetrating keratoplasty (PKP) were done when necessary. Visual acuity was measured 1 week following intervention and at the last follow-up.

Results: Congenital (17 eyes, 43.6%), developmental (11 eyes, 28.2%), and traumatic (11 eyes, 28.2%) cataract were the indications for surgery. Posterior capsule opacification (34 eyes, 87.2%), updrawn pupil (15 eyes, 38.5%), decentered IOL (13 eyes, 33.3%), and pupillary capture (12 eyes, 30.8%) were the major complications. An Nd:YAG capsulotomy was attempted in 19 eyes (48.7%). Surgical membranectomy was performed in 10 eyes (25.6%); PKP was performed in 2 eyes (5.1%) to treat pseudophakic bullous keratopathy. One eye had to be eviscerated because of uncontrolled endophthalmitis. In 31 eyes in which visual acuity could be measured, 27 had an acuity of 6/60 or worse at the time of presentation. Following intervention and amblyopia therapy, 19 eyes achieved a visual acuity of 6/18 or better.

Conclusion: Routine ECCE with IOL implantation in pediatric eyes is associated with various problems and may lead to permanent visual disability.

Publication types

  • Comparative Study

MeSH terms

  • Capsulorhexis / adverse effects*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Lasers, Excimer
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular / adverse effects*
  • Male
  • Photorefractive Keratectomy
  • Postoperative Complications* / etiology
  • Postoperative Complications* / surgery
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy