Pediatric Cataract Surgery: Unexpected Returns to the Operating Room within One Year
William J. Johnson, MD; M. Edward Wilson, MD; Rupal Trivedi, MD
Storm Eye Institute, Medical University of South Carolina
Charleston, South Carolina
Introduction: Previous studies have provided excellent data regarding the reoperation rates for infant eyes undergoing cataract surgery at less than 7-months of age. At present, generalizable data for incidence of unplanned return to the operating room following cataract surgery in the full spectrum of the pediatric age group are not readily available.
Methods: Retrospective chart review, with IRB approval, was carried out for eyes undergoing cataract surgery at a single institution 8/2012 through 8/2015, examining unexpected returns to the operating room. Age over 18 and ectopia lentis were excluded.
Results: One-hundred sixty-three (163) eyes met inclusion criteria. Fifteen (9.2%) eyes were unexpectedly re-operated within 1-year of cataract extraction, encompassing twenty additional surgeries. Eyes of children 7-months of age and older at the time of surgery demonstrated a reoperation rate of 2.6% (3 of 114 eyes), with those younger than 7 months of age exhibiting 24.5% (12 of 49 eyes) (Relative risk: 9.5, P = 0.0003). Total reoperations included 10 for after-cataract , 7 for glaucoma, 1 pupilloplasty, 1 retained lens cortex, and 1 for a vitreous strand.
Discussion: The results offered by this cohort demonstrate a reoperation rate indicative of the inherent risk of undergoing surgery at a younger age, with equally robust evidence of the decreased incidence of older patients within the same consecutive cohort. These data may assist with counseling parents and patients, as well as assessing for quality.
Conclusion: Rate of return for older infants and children decreases dramatically compared with eyes undergoing operation in early infancy.