EFFECT OF CORNEAL ASTIGMATISM ON POSTOPERATIVE VISUAL OUTCOMES IN CHILDREN WITH CONGENITAL CATARACTS

: Congenital cataract (CC) represents a pediatric ocular condition that affects visual development from birth. Its impact varies with the cataract's characteristics and the timing of surgical intervention. While existing research extensively covers the dynamics of eye growth and vision development, the role of corneal astigmatism (CA) in influencing postoperative visual outcomes often remains unanalyzed. However, evidence suggests that CA significantly affects visual function development in healthy children, highlighting the need for a similar detailed analysis in CC cases. Objective: This study aimed to evaluate the influence of corneal astigmatism on the visual outcomes following surgery in children with congenital cataract. Material and methods. Conducted at the Kazakh Eye Research Institute, this retrospective case-control study involved 109 patients (169 eyes) diagnosed with CC. Comprehensive ophthalmological assessments were performed: data such as patient age, visual acuity before and after surgery, and CA were included for analysis. Patients were categorized based on CA into two groups: CA ≥ 1.0 D (main group) and CA < 1.0 D (control group). Results. The majority of patients (84.6%) had CA ≥ 1.0 D. The mean CA was significantly higher in the main group compared to the control group (3.94 D vs. 0.61 D, p < 0.001). Although preoperative BCVA did not significantly differ between groups, postoperative BCVA was notably better in the control group (0.59 vs. 0.41, p < 0.001). A negative correlation was identified between CA and postoperative BCVA, although weak (r = -0.2243 (95% Confidence Interval) from -0.3778 to -0.05875), indicating worse visual outcomes with higher CA levels. Conclusion. Our findings showed the significant negative correlation between CA and BCVA after surgery emphasizing the critical consideration of CA in surgical planning and rehabilitation. The observed negative impact of CA on visual outcomes calls for a newer treatment approach to enhance functional outcomes after CC surgery