Presence of Posterior Staphyloma in Congenital Cataract Children

ABSTRACT

Purpose: To investigate the prevalence of posterior staphyloma (PS) in congenital cataract children and its role in predicting postoperative axial elongation.

Materials and Methods: Preoperative prevalence of PS in 520 congenital cataract patients was reviewed and compared with that of the healthy eyes of 300 unilateral traumatic cataract children after 1:1 propensity score matching. Then, 32 pseudophakic children with preoperative PS and 48 age-matched pseudophakic controls without preoperative PS were followed up after the surgery, to compare their axial growth rates and refractive changes.

Results: Congenital cataract was significantly associated with the presence of PS (OR: 14.88, P = .009) after propensity score matching. Even in congenital cataract eyes with axial length <26 mm, 5% were identified with PS on B-scan: ≤22 mm: 3%, 22–24 mm: 5% and 24–26 mm: 13%. Eyes with preoperative PS exhibited faster postoperative axial growth than those without, especially in bilateral cases or in children undergoing surgery before 8 years old (≤4 years: 0.53 ± 0.33 vs 0.30 ± 0.21 mm/y P = .028; 4–8 years: 0.37 ± 0.26 vs 0.23 ± 0.15 mm/y P = .044). Myopic shift after surgery was also more significant in children with preoperative PS than in those without (−1.10 ± 0.50 vs −0.60 ± 0.47D/y, P < .001).

Conclusions: Congenital cataract is a risk factor for PS. Preoperative PS in pediatric cataract eyes may be an indicator of excessive postoperative axial elongation, especially in bilateral cases or in cases undergoing cataract surgery at a younger age. Our findings may also promote better clinical decision-making in intraocular lens power selection for pediatric population.

KEYWORDS:

• Congenital cataract
• posterior staphyloma
• axial length
• myopic shift

Author contributions

Study design (X.J.Z.); study performance (Y.D., W.W.H.); data collection and management (W.W.H., Y.D., T.S., J.Y.); data analysis and interpretation (Y.D., W.W.H., T.S., J.Y.); writing and review of the manuscript (X.J.Z., Y.L., C.L.K., Q.G.X.). All the authors have approved the manuscript.

Disclosure statement

No author has conflict of interest to report.

Additional information

Funding

Publication of this article was supported by research grants from the National Natural Science Foundation of the People’s Republic of China (grant nos. 81870642, 81470613, 81670835, and 81270989), the Shanghai Pediatric Cataract Study, the Shanghai Talent Development Fund (grant no. 201604), the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission (grant no. 2017YQ011).