Background: Pars plana lensectomy with subsequent fitting of contact lenses is the standard procedure for cataracts occurring within the first 2 years of life. We wanted to assess the outcome and complication rate of this procedure.
Methods: Pars plana lensectomy was performed on 29 eyes of 15 children with bilateral as well as 12 eyes with unilateral cataracts. All children were reexamined at an age of at least 3 years.
Results: In bilateral cases the mean age at the time of surgery was 4.0 months and mean resulting visual acuity 0.32. After exclusion of three eyes with complications or bad postoperative compliance, we found a statistically significant correlation between age at surgery and visual acuity (r(2)=0.432, p<0.05). Some form of binocular vision was achieved by 40% of the children; 17% developed ocular hypertension and 7% a secondary cataract. In the unilateral cases the mean age at surgery was 3.9 months and the mean resulting visual acuity 0.14. There was no significant correlation between age and visual acuity; 17% gained binocular function and 5% had ocular hypertension.
Conclusion: Visual function after lensectomy is better in eyes with bilateral cataracts compared to unilateral cataracts. Early surgery as well as adequate orthoptic therapy and compliance with wearing the contact lens are necessary for good outcome.