Unilateral cataract extraction outcomes in older children compared to two studies with younger cohorts
Reviewed by Lauren Hepworth

The authors present a retrospective study of children undergoing cataract surgery between the ages of two and seven-years-old at one centre, over a 24-year period. Data including demographics, ocular history, ophthalmic findings, operative reports, adverse events, and record of re-operations was extracted from the medical notes. Inclusion required at least two years follow-up. Exclusion criteria included diagnosis of anterior segment, retinal or optic nerve disease, the child being younger than five years at final follow-up and trauma being the cataract aetiology. The authors highlight how the definition of adverse events differ from those published by the Infant Aphakia Treatment Study (IATS). This includes the development of posterior capsule opacification not being deemed an adverse event in this study. A total of 68 children were included in this study, following exclusion of 60 cases the majority of which had shorter follow-up than the required two years. The mean age at time of surgery was 4.5 years. The findings from this cohort were compared the results available in the published literature from the cohorts of the IATS and Toddler Aphakic and Pseudophakic Study (TAPS). The authors report fewer intraoperative complications and better visual acuity outcomes in this older cohort. Findings with regard to no development of glaucoma and a reduced number of additional unplanned surgeries were similar to the TAPS compared to the infants in IATS. This study allows relevant risks to be discussed during the informed consent process for the surgical removal of a visually significant cataract.

Outcomes of unilateral cataract surgery in children 2-7 years of age: a comparison to surgery in toddlers and infants.
Anastasia AA, Adams C, Trivedi RH, Wilson ME.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2022;26(4):169.