[Visual and sensory results of surgical treatment of cataract in children. Apropos of 135 cases].

PURPOSE

Visual outcome after cataract surgery in children.

METHODS

The authors studied the functional results (visual acuity and binocular vision) of 135 children operated for unilateral or bilateral cataracts during the 9-year period 1985-1994. Aphakia was corrected by an implant within the capsular bag, spectacles or contact lenses.

RESULTS

For bilateral cataracts, (68 patients), mean visual acuity > 20/40 and normal binocular vision are found together in cases of late appearance operated after 7 months of age. Pseudophakic eyes regained visual acuity greater than 20/40 more often than non-implanted eye, with a statistically significant difference (P < 0.001). Binocular vision was also obtained more often in children after implantation (P < 0.05). The functional results of operations on early cataracts treated before the age of 8 months were not as good because of abnormal development of the foveolar function. For unilateral cataracts (67 patients), the prognosis was poor when operated before the age of 8 months. Visual acuity rarely exceeded 20/200 however the aphakia was corrected. Prognosis was better for partial cataracts and late-appearing cataracts. Implantation appeared to be of more benefit, with a statistically significant difference (P < 0.05) for visual acuity greater than 20/40 in children receiving an implant.

CONCLUSION

Regained binocular vision and absence of amblyopia depend on the quality of previous visual experience and absence of post-operative strabismus. Implantation appears beneficial for final visual results.