Visual outcome of cataract surgery in children with congenital rubella syndrome.

OBJECTIVE

To evaluate visual outcome after cataract surgery in children with congenital rubella syndrome (CRS).

METHODS

A retrospective analysis was conducted on 40 eyes of 22 children with CRS who underwent cataract surgery. Thirty-six eyes underwent lensectomy with anterior vitrectomy, and 4 eyes underwent extracapsular cataract extraction with primary posterior capsulectomy. The median age at surgery was 6 months, and median duration of postoperative follow up was 68.5 months. Each follow-up visit consisted of visual acuity estimation, refraction, anterior and posterior segment examination, and intraocular pressure measurements.

RESULTS

Visual acuity at final follow up was 6/24 or better in 6 (15.0%) eyes, and 22 (55.0%) eyes had visual acuity less than 3/60. Postoperative complications included transient corneal edema in 18 (45.0%) eyes, glaucoma in 5 (12.5%) eyes, after cataract in 1 (2.5%) eye, and hyphema in 1 (2.5%) eye. Ocular disorders affecting visual outcome included stimulus deprivation amblyopia, glaucoma, optic atrophy, corneal opacity, and after cataract. Associated systemic disorders included neurological problems in 15 (68.2%), hearing loss in 12 (54.6%), cardiovascular problems in 9 (40.9%), and speech abnormalities in 7 (31.8%) children.

CONCLUSIONS

The less-than-optimal postoperative visual outcome suggests the need to look at primary prevention of rubella, especially in developing countries.