Journal article
Complications Occurring Through 5 Years Following Primary Intraocular Lens Implantation for Pediatric Cataract
JAMA ophthalmology, Vol.141(8), pp.705-714
2023
DOI: 10.1001/jamaophthalmol.2023.2335
PMCID: PMC10288374
PMID: 37347490
Abstract
Importance Lensectomy with primary intraocular lens (IOL) implantation is often used in the management of nontraumatic pediatric cataract, but long-term data evaluating the association of age and IOL location with the incidence of complications are limited. Objective To describe the incidence of complications and additional eye surgeries through 5 years following pediatric lensectomy with primary IOL implantation and association with age at surgery and IOL location. Design, Setting, and Participants This prospective cohort study used Pediatric Eye Disease Investigator Group cataract registry data from 61 institution- and community-based practices over 3 years (June 2012 to July 2015). Participants were children younger than 13 years without baseline glaucoma who had primary IOL implantation (345 bilateral and 264 unilateral) for nontraumatic cataract. Data analysis was performed between September 2021 and January 2023. Exposures Lensectomy with primary IOL implantation. Main Outcome and Measures Five-year cumulative incidence of complications by age at surgery (<2 years, 2 to <4 years, 4 to <7 years, and 7 to <13 years) and by IOL location (sulcus vs capsular bag) were estimated using Cox proportional hazards models. Results The cohort included 609 eyes from 491 children (mean [SD] age, 5.6 [3.3] years; 261 [53%] male and 230 [47%] female). Following cataract extraction with primary IOL implantation, a frequent complication was surgery for visual axis opacification (VAO) (cumulative incidence, 32%; 95% CI, 27%-36%). Cumulative incidence was lower with anterior vitrectomy at the time of IOL placement (12%; 95% CI, 8%-16%) vs without (58%; 95% CI, 50%-65%), and the risk of undergoing surgery for VAO was associated with not performing anterior vitrectomy (hazard ratio [HR], 6.19; 95% CI, 3.70-10.34; P < .001). After adjusting for anterior vitrectomy at lens surgery, there were no differences in incidence of surgery for VAO by age at surgery (<2 years, HR, 1.35 [95% CI, 0.63-2.87], 2 to <4 years, HR, 0.86 [95% CI, 0.44-1.68], 4 to <7 years, HR, 1.06 [95% CI, 0.72-1.56]; P = .74) or by capsular bag vs sulcus IOL fixation (HR, 1.22; 95% CI, 0.36-4.17; P = .75). Cumulative incidence of glaucoma plus glaucoma suspect by 5 years was 7% (95% CI, 4%-9%), which did not differ by age after controlling for IOL location and laterality. Conclusions and Relevance In this cohort study, a frequent complication following pediatric lensectomy with primary IOL was surgery for VAO, which was associated with primary anterior vitrectomy not being performed but was not associated with age at surgery or IOL location. The risk of glaucoma development across all ages at surgery suggests a need for long-term monitoring.
Details
- Title: Subtitle
- Complications Occurring Through 5 Years Following Primary Intraocular Lens Implantation for Pediatric Cataract
- Creators
- Kimberly G. Yen - Texas Children's HospitalMichael X. Repka - National Eye InstituteDesirae R. Sutherland - Jaeb Center for Health ResearchKathryn M. Haider - Riley Hospital for ChildrenSarah R. Hatt - Mayo ClinicRaymond T. Kraker - Jaeb Center for Health ResearchJennifer A. Galvin - Yale UniversityZhuokai Li - Jaeb Center for Health ResearchSusan A. Cotter - Marshall B. Ketchum UniversityJonathan M. Holmes - University of ArizonaSharon F. Freedman - for the Pediatric Eye Disease Investigator GroupDavid K. Wallace - for the Pediatric Eye Disease Investigator GroupLaura B. Enyedi - for the Pediatric Eye Disease Investigator GroupSasapin Prakalapakorn - for the Pediatric Eye Disease Investigator GroupSarah K. Jones - for the Pediatric Eye Disease Investigator GroupDenise Hug - for the Pediatric Eye Disease Investigator GroupErin D. Stahl - for the Pediatric Eye Disease Investigator GroupRebecca J. Dent - for the Pediatric Eye Disease Investigator GroupLingkun Kong - for the Pediatric Eye Disease Investigator GroupSerena Wang - for the Pediatric Eye Disease Investigator GroupBryan K. Gallerson - for the Pediatric Eye Disease Investigator GroupAmy K. Hutchinson - for the Pediatric Eye Disease Investigator GroupPhoebe Lenhart - for the Pediatric Eye Disease Investigator GroupJudy Brower - for the Pediatric Eye Disease Investigator GroupDavid G. Morrison - for the Pediatric Eye Disease Investigator GroupScott T. Ruark - for the Pediatric Eye Disease Investigator GroupRebecca Mets-Halgrimson - for the Pediatric Eye Disease Investigator GroupHawke Yoon - for the Pediatric Eye Disease Investigator GroupHantamalala Ralay-Ranaivo - for the Pediatric Eye Disease Investigator GroupAaliyah Hamidullah - for the Pediatric Eye Disease Investigator GroupRaymond Areaux - for the Pediatric Eye Disease Investigator GroupJill S. Anderson - for the Pediatric Eye Disease Investigator GroupAnn M. Holleschau - for the Pediatric Eye Disease Investigator GroupRosanne Superstein - for the Pediatric Eye Disease Investigator GroupCaroline Belanger - for the Pediatric Eye Disease Investigator GroupNicole Fallaha - for the Pediatric Eye Disease Investigator GroupPatrick Hamel - for the Pediatric Eye Disease Investigator GroupMaryse Thibeault - for the Pediatric Eye Disease Investigator GroupSusanna M. Tamkins - for the Pediatric Eye Disease Investigator GroupTa Chang - for the Pediatric Eye Disease Investigator GroupHee-Jung S. Park - for the Pediatric Eye Disease Investigator GroupAnya A. Trumler - for the Pediatric Eye Disease Investigator GroupXiaonong Liu - for the Pediatric Eye Disease Investigator GroupWilliam F. Astle - for the Pediatric Eye Disease Investigator GroupEmi N. Sanders - for the Pediatric Eye Disease Investigator GroupElias Traboulsi - for the Pediatric Eye Disease Investigator GroupFatema Ghasia - for the Pediatric Eye Disease Investigator GroupDiana C. McOwen - for the Pediatric Eye Disease Investigator GroupMichael E. Gray - for the Pediatric Eye Disease Investigator GroupMichael B. Yang - for the Pediatric Eye Disease Investigator GroupCorey S. Bowman - for the Pediatric Eye Disease Investigator GroupMargaret Therriault - for the Pediatric Eye Disease Investigator GroupHeather Smith - for the Pediatric Eye Disease Investigator GroupMichele E. Whitaker - for the Pediatric Eye Disease Investigator GroupFaruk Orge - for the Pediatric Eye Disease Investigator GroupAdriana P. Grigorian - for the Pediatric Eye Disease Investigator GroupAlicia M. Baird - for the Pediatric Eye Disease Investigator GroupMitchell B. Strominger - for the Pediatric Eye Disease Investigator GroupVicki Chen - for the Pediatric Eye Disease Investigator GroupShelley Klein - for the Pediatric Eye Disease Investigator GroupJacquelyn D. Kemmer - for the Pediatric Eye Disease Investigator GroupAlexandra E. Neiman - for the Pediatric Eye Disease Investigator GroupMyra N. Mendoza - for the Pediatric Eye Disease Investigator GroupJill J. Frohwein - for the Pediatric Eye Disease Investigator GroupDon Bremer - for the Pediatric Eye Disease Investigator GroupCybil Cassady - for the Pediatric Eye Disease Investigator GroupRichard Golden - for the Pediatric Eye Disease Investigator GroupCatherine Jordan - for the Pediatric Eye Disease Investigator GroupDavid Rogers - for the Pediatric Eye Disease Investigator GroupSara A. Oravec - for the Pediatric Eye Disease Investigator GroupTammy L. Yanovitch - for the Pediatric Eye Disease Investigator GroupKeven Lunsford - for the Pediatric Eye Disease Investigator GroupChristina Nye - for the Pediatric Eye Disease Investigator GroupCaroline Shea - for the Pediatric Eye Disease Investigator GroupSueAnn M. Stillman - for the Pediatric Eye Disease Investigator GroupG. Robert LaRoche - for the Pediatric Eye Disease Investigator GroupStephen C. Van Iderstine - for the Pediatric Eye Disease Investigator GroupElisa Robertson - for the Pediatric Eye Disease Investigator GroupOscar A. Cruz - for the Pediatric Eye Disease Investigator GroupRafif Ghadban - for the Pediatric Eye Disease Investigator GroupDawn Govreau - for the Pediatric Eye Disease Investigator GroupScott A. Larson - for the Pediatric Eye Disease Investigator GroupSusannah Longmuir - for the Pediatric Eye Disease Investigator GroupXiaoyan Shan - for the Pediatric Eye Disease Investigator GroupMichael P. Clarke - for the Pediatric Eye Disease Investigator GroupKate Taylor - for the Pediatric Eye Disease Investigator GroupChristine Powell - for the Pediatric Eye Disease Investigator GroupBenjamin P. Hammond - for the Pediatric Eye Disease Investigator GroupMatthew D. Gearinger - for the Pediatric Eye Disease Investigator GroupAndrea Czubinski - for the Pediatric Eye Disease Investigator GroupDorothy H. Hendricks - for the Pediatric Eye Disease Investigator GroupJing Jin - for the Pediatric Eye Disease Investigator GroupJonathan H. Salvin - for the Pediatric Eye Disease Investigator GroupAlicia Fisher - for the Pediatric Eye Disease Investigator GroupKatherine A. Lee - for the Pediatric Eye Disease Investigator GroupDaniel Brooks - for the Pediatric Eye Disease Investigator GroupBonita R. Schweinler - for the Pediatric Eye Disease Investigator GroupNicholas A. Sala - for the Pediatric Eye Disease Investigator GroupAllyson M. Sala - for the Pediatric Eye Disease Investigator GroupAllison I. Summers - for the Pediatric Eye Disease Investigator GroupDaniel J. Karr - for the Pediatric Eye Disease Investigator GroupLorri B. Wilson - for the Pediatric Eye Disease Investigator GroupPaula K. Rauch - for the Pediatric Eye Disease Investigator GroupMary O'Hara - for the Pediatric Eye Disease Investigator GroupNandini Gandhi - for the Pediatric Eye Disease Investigator GroupTania Hashmi - for the Pediatric Eye Disease Investigator GroupJeffrey Colburn - for the Pediatric Eye Disease Investigator GroupEileen Dittman - for the Pediatric Eye Disease Investigator GroupCharles R. Whitfill - for the Pediatric Eye Disease Investigator GroupAmy M. Wheeler - for the Pediatric Eye Disease Investigator GroupEmily A. McCourt - for the Pediatric Eye Disease Investigator GroupJasleen Singh - for the Pediatric Eye Disease Investigator GroupNanastasia Welnick - for the Pediatric Eye Disease Investigator GroupNathalie F. Azar - for the Pediatric Eye Disease Investigator GroupJoseph Baker - for the Pediatric Eye Disease Investigator GroupPatrick J. Droste - for the Pediatric Eye Disease Investigator GroupRobert J. Peters - for the Pediatric Eye Disease Investigator GroupJan Hilbrands - for the Pediatric Eye Disease Investigator GroupStacy L. Pineles - for the Pediatric Eye Disease Investigator GroupMarianne J. Bernardo - for the Pediatric Eye Disease Investigator GroupEdward Peterson - for the Pediatric Eye Disease Investigator GroupCharla H. Peterson - for the Pediatric Eye Disease Investigator GroupKartik Kumar - for the Pediatric Eye Disease Investigator GroupEphrem Melese - for the Pediatric Eye Disease Investigator GroupRobert Lingua - for the Pediatric Eye Disease Investigator GroupJeff Grijalva - for the Pediatric Eye Disease Investigator GroupEarl R. Crouch - for the Pediatric Eye Disease Investigator GroupGaylord Ventura - for the Pediatric Eye Disease Investigator GroupWilliam Anninger - for the Pediatric Eye Disease Investigator GroupShawn L. Benson - for the Pediatric Eye Disease Investigator GroupKaren A. Karp - for the Pediatric Eye Disease Investigator GroupJordana M. Smith - for the Pediatric Eye Disease Investigator GroupJill Brickman-Kelleher - for the Pediatric Eye Disease Investigator GroupBenjamin H. Ticho - for the Pediatric Eye Disease Investigator GroupAlexander J. Khammar - for the Pediatric Eye Disease Investigator GroupDeborah A. Clausius - for the Pediatric Eye Disease Investigator GroupSuquin Guo - for the Pediatric Eye Disease Investigator GroupDonny Suh - for the Pediatric Eye Disease Investigator GroupCarolyn Chamberlain - for the Pediatric Eye Disease Investigator GroupSusan Schloff - for the Pediatric Eye Disease Investigator GroupWilliam P. Madigan - for the Pediatric Eye Disease Investigator GroupDonna Burkman - for the Pediatric Eye Disease Investigator GroupStephen P. Christiansen - for the Pediatric Eye Disease Investigator GroupJean E. Ramsey - for the Pediatric Eye Disease Investigator GroupKate H. McConnell - for the Pediatric Eye Disease Investigator GroupIlana Friedman - for the Pediatric Eye Disease Investigator GroupJose Rosado - for the Pediatric Eye Disease Investigator GroupDonald P. Sauberan - for the Pediatric Eye Disease Investigator GroupJody C. Hemberger - for the Pediatric Eye Disease Investigator GroupPatricia L. Davis - for the Pediatric Eye Disease Investigator GroupIndre Rudaitis - for the Pediatric Eye Disease Investigator GroupRobert S. Lowery - for the Pediatric Eye Disease Investigator GroupShawn Cupit - for the Pediatric Eye Disease Investigator GroupErick D. Bothun - for the Pediatric Eye Disease Investigator GroupBrian G. Mohney - for the Pediatric Eye Disease Investigator GroupSuzanne M. Wernimont - for the Pediatric Eye Disease Investigator GroupRebecca A. Neilsen - for the Pediatric Eye Disease Investigator GroupErin P. Herlihy - for the Pediatric Eye Disease Investigator GroupFrancine Baran - for the Pediatric Eye Disease Investigator GroupAmy Gladstone - for the Pediatric Eye Disease Investigator GroupJustin Smith - for the Pediatric Eye Disease Investigator GroupMei Mellott - for the Pediatric Eye Disease Investigator GroupTroy Kieser - for the Pediatric Eye Disease Investigator GroupS. Ayse Erzurum - for the Pediatric Eye Disease Investigator GroupBeth Colon - for the Pediatric Eye Disease Investigator GroupBirva Shah - for the Pediatric Eye Disease Investigator GroupMicaela Quebbemann - for the Pediatric Eye Disease Investigator GroupRoy W. Beck - for the Pediatric Eye Disease Investigator GroupDarrell S. Austin - for the Pediatric Eye Disease Investigator GroupNicole M. Boyle - for the Pediatric Eye Disease Investigator GroupCourtney L. Conner - for the Pediatric Eye Disease Investigator GroupDanielle L. Chandler - for the Pediatric Eye Disease Investigator GroupQuayleen Donahue - for the Pediatric Eye Disease Investigator GroupBrooke P. Fimbel - for the Pediatric Eye Disease Investigator GroupJulianne L. Robinson - for the Pediatric Eye Disease Investigator GroupAmra Hercinovic - for the Pediatric Eye Disease Investigator GroupJames E. Hoepner - for the Pediatric Eye Disease Investigator GroupJoseph D. Kaplon - for the Pediatric Eye Disease Investigator GroupRobert J. Henderson - for the Pediatric Eye Disease Investigator GroupB. Michele Melia - for the Pediatric Eye Disease Investigator GroupGillaine Ortiz - for the Pediatric Eye Disease Investigator GroupVictoria C. Woodard - for the Pediatric Eye Disease Investigator GroupKathleen M. Stutz - for the Pediatric Eye Disease Investigator GroupRui Wu - for the Pediatric Eye Disease Investigator GroupDonald F. Everett - for the Pediatric Eye Disease Investigator GroupMarie Diener-West - for the Pediatric Eye Disease Investigator GroupJohn D. Baker - for the Pediatric Eye Disease Investigator GroupBarry Davis - for the Pediatric Eye Disease Investigator GroupDale L. Phelps - for the Pediatric Eye Disease Investigator GroupStephen W. Poff - for the Pediatric Eye Disease Investigator GroupRichard A. Saunders - for the Pediatric Eye Disease Investigator GroupLawrence Tychsen - for the Pediatric Eye Disease Investigator GroupYasmin S. Bradfield - for the Pediatric Eye Disease Investigator GroupNicole C. Foster - for the Pediatric Eye Disease Investigator GroupDavid A. Plager - for the Pediatric Eye Disease Investigator GroupDaniel J. Salchow - for the Pediatric Eye Disease Investigator GroupEileen E. Birch - for the Pediatric Eye Disease Investigator GroupRuth E. Manny - for the Pediatric Eye Disease Investigator GroupJayne L. Silver - for the Pediatric Eye Disease Investigator GroupKatherine K. Weise - for the Pediatric Eye Disease Investigator GroupLisa C. Verderber - for the Pediatric Eye Disease Investigator GroupTrevano W. Dean - for the Pediatric Eye Disease Investigator GroupAlejandra G. de Alba Campomanes - for the Pediatric Eye Disease Investigator GroupMarielle P. Young - for the Pediatric Eye Disease Investigator GroupBahram Rahmani - for the Pediatric Eye Disease Investigator GroupGeorge F. Whitehead - for the Pediatric Eye Disease Investigator GroupScott R. Lambert - for the Pediatric Eye Disease Investigator GroupSudhi P. Kurup - for the Pediatric Eye Disease Investigator GroupCourtney L. Kraus - for the Pediatric Eye Disease Investigator GroupPediatric Eye Disease Investigator Group
- Resource Type
- Journal article
- Publication Details
- JAMA ophthalmology, Vol.141(8), pp.705-714
- DOI
- 10.1001/jamaophthalmol.2023.2335
- PMID
- 37347490
- PMCID
- PMC10288374
- NLM abbreviation
- JAMA Ophthalmol
- ISSN
- 2168-6165
- eISSN
- 2168-6173
- Language
- English
- Electronic publication date
- 06/22/2023
- Date published
- 2023
- Academic Unit
- Ophthalmology and Visual Sciences
- Record Identifier
- 9984442224702771
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