Cataract surgery in infants with microphthalmos

To report the postoperative outcomes of cataract surgery in microphthalmic eyes of infants.

This prospective observational study was carried out on 20 infants with microphthalmos with visually significant cataract. Microphthalmos was defined as axial length of the globe 16.50 mm or less. We excluded eyes with ocular trauma, inflammation, posterior hyperplastic primary vitreous or a tractional retinal detachment, aniridia, or chorioretinal coloboma. All the infants enrolled in this study underwent phacoaspiration with primary posterior capsulotomy, anterior vitrectomy, and peripheral iridectomy. Intraocular lens was not implanted in these children. Post-operative evaluation included refractive errors, irregularity of pupil, posterior synechiae, visual axis obscuration, and intraocular pressure. These children were followed up for a minimum of 12 months.

We evaluated 37 eyes of 20 infants, of whom 17 infants had bilateral and three infants had unilateral cataract. The mean age of the children and the mean axial length at the time of surgery were 3.78 ± 2.25 months and 15.76 ± 0.56 mm respectively. The complications observed were irregularity of pupil in seven eyes (18.9 %), glaucoma in five eyes (13.5 %), posterior synechiae in two eyes (5.2 %), visual axis obscuration due to posterior capsule opacification (PCO) in two eyes (5.2 %) and phthisis in one eye (2.7 %).

Infants achieved a favorable outcome after phacoaspiration with primary posterior capsulotomy with anterior vitrectomy. However, these children must be followed up to detect and treat postoperative complications such as visual axis obscuration, posterior synechiae, and glaucoma to achieve optimal outcome.