Cataract Formation Following Pars Plana Vitrectomy in the Pediatric Population

Abstract

Purpose: To analyze post-vitrectomy cataract formation in the pediatric population to elucidate the number of phakic children requiring cataract surgery following vitreous surgery and the perioperative factors affecting cataract development in these patients. Methods: Eyes of pediatric patients that underwent phakic pars plana vitrectomy (PPV) with no prior cataract in a 10-year period were included. Analyses evaluated relationships between patient age and time to cataract surgery, as well as contributing factors for cataract formation. Final visual outcomes were also examined. Outcomes were collected for patient age at first vitrectomy, indication for vitrectomy, use of tamponade agents, history of ocular trauma, cataract status, and time to cataract surgery from first vitrectomy. Results: Of 44 eyes analyzed, 27 (61%) were noted to have some degree of cataract formation. Of these, 15 (56%; 34% of total eyes) underwent cataract surgery. Use of octafluoropropane ( P = .04) or silicone oil ( P = .03) positively correlated with the need for cataract surgery in the total study group. Patients requiring cataract surgery had worse endpoint visual acuities than those who did not undergo surgery ( P = .02), although this difference becomes less significant in follow-up over 2 years ( P = .30). Patients who had cataracts but did not need cataract surgery showed an improvement in visual acuity ( P = .04), but this was not demonstrated in patients who did need cataract surgery ( P = .90). Conclusions: Pediatric eye care providers should be aware of the significant risk of cataract formation following a phakic PPV. [ J Pediatr Ophthalmol Strabismus . 2023;60(6):421–426.]