Outcome of cataract surgery in patients less than three years of age

To evaluate the outcomes of cataract surgery in children younger than three years, specifically surgical techniques, complications, and postoperative visual acuity. This prospective observational study was conducted at Kasturba Hospital, Manipal, between September 2017 and August 2019. Children under three years old undergoing cataract surgery with at least six months of postoperative follow-up were enrolled. Data collected included surgical procedures, patient demographics, and outcomes, which were analyzed using descriptive statistics. The study included 60 eyes of 37 patients. Bilateral cataracts were present in 62.16% of patients, and congenital cataracts were the most common (56.75%). The most frequent surgical techniques were lens aspiration with posterior primary capsulotomy, anterior vitrectomy, and peripheral iridectomy. Intraocular lens (IOL) implantation was performed in 61.66% of eyes. Postoperative optical rehabilitation consisted of IOLs (61.66%), aphakic glasses (33.34%), and contact lenses (5%). Visual acuity improved in 50% of eyes postoperatively. Complications were observed in 33.33% of eyes, with posterior capsular opacification being the most common (16.67%). Glaucoma was rare (1.67%). The study's limitations included a small sample size and variations in surgical techniques among the four surgeons. Lens aspiration with primary posterior capsulotomy and anterior vitrectomy, with or without IOL implantation, appears to be a safe and effective procedure for pediatric cataracts in children under three, demonstrating notable postoperative visual improvement. Larger, standardized studies are necessary to validate these findings and optimize surgical techniques.