Outcomes of Bilateral Cataract Surgery in Infants 7 to 24 Months of Age: Toddler Aphakia and Pseudophakia Study (TAPS).

Purpose To evaluate outcomes of bilateral cataract surgery in children ages 7-24 months and compare rates of adverse events (AE) to other Toddler Aphakia and Pseudophakia Study (TAPS) registry outcomes. Design Retrospective clinical study at 10 IATS sites. Statistical analyses comparing this cohort to previously reported TAPS registry cohorts. Participants Children enrolled in the TAPS registry between 2004 and 2010. Intervention Children underwent bilateral cataract surgery with or without intraocular lens (IOL) placement at age 7-24 months with 5 years of post-surgical follow-up. Main Outcome Measures Visual acuity, occurrence of strabismus, adverse events (AE), reoperations. Results 40 children (76 eyes) who underwent bilateral cataract surgery with primary posterior capsulectomy were identified with a median age at cataract surgery of 13 months (7-23); 68% received a primary intraocular lens (IOL). Recurrent visual axis opacification (VAO) occurred in 7.5% and was associated only with the use of an IOL (Odds Ratio 6.10, p=0.005). Glaucoma suspect (GS) was diagnosed in 2.5%, but no child developed glaucoma. In this bilateral cohort, AEs (8/40, 20%), including glaucoma or GS and VAO, and reoperations occurred in a similar proportion to that of the published unilateral TAPS cohort. When analyzed with children 1-7 months at bilateral surgery, the incidence of AEs and glaucoma or GS correlated strongly with age at surgery (p=0.011/0.004) and glaucoma correlated with microcornea (p=0.040) but not with IOL insertion (p=0.15). Conclusions Follow-up to age 5 years after bilateral cataract surgery in children 7-24 months reveals a low rate of VAO and very rare glaucoma or GS diagnosis compared to infants with cataracts operated