Outcomes of Cataract Surgery in Adult Patients with Down's Syndrome
To describe the outcomes of cataract surgery in adult patients with Down's syndrome at a tertiary eye hospital in Hong Kong, the following retrospective case-file analysis was performed. Patients with Down's syndrome who underwent cataract surgery between January 2002 and December 2012 were identified and morphology of cataract, associated ocular features and surgical and visual outcomes were analyzed.
Cataract surgery was performed in 33 eyes of 20 patients (12 males, eight females, mean age 42.9 ± 10.6 years) over a 10-year period. Nine patients (nine/20, 45.0%) had bilateral cataracts at the time of diagnosis, and white cataracts were noted in 12 eyes of 10 patients (12/33, 36.3%) at the time of presentation. Associated ocular problems included myopic maculopathy (18 eyes, 54.5%), keratoconus (12 eyes, 36.3%), nystagmus (two eyes, 6.0%), corneal scar (two eyes, 6.0%) and glaucoma (two eyes, 6.0%). Five eyes (15.1%) underwent extracapsular cataract extraction, whereas a phacoemulsification was performed in 28 (84.9%) eyes. Intraocular lens implantation was performed in 32/33 eyes. The most common postoperative complication was posterior capsular opacification (eight eyes, 24.2%). Moreover, the mean best-corrected visual acuity improved from 0.07 ± 0.11 preoperatively to 0.17 ± 0.19 at three months postoperatively (p=0.000).
A high incidence of bilateral cataracts as well as white cataracts was observed in patients with Down's syndrome in this study. Although the surgical outcomes of cataract surgery were good, the visual outcomes were suboptimal in these cases due to associated ocular comorbidities.