To assess long term visual outcomes after congenital cataract surgery at Imam Hossein Medical Center from 2001 to 2011.

In this retrospective study, data of 60 patients with congenital cataract were selected who had been operated up to age 16. Patients with mental retardation, systemic and ocular disorders, uncooperative children and less than five years old were excluded. The average of follow-up examinations was 5 years. In cases with incomplete records, further ocular examinations were performed after recruitment. Finally, the records of 42 patients (71 eyes) were completed and analyzed.

20 males and 22 females with the mean age of 11.8 ± 6 years were participated. 29(69%) and 13 (31%) patients had bilateral and unilateral cataract, respectively. Their median age of surgery and surgical interval between two eyes was 3 years and 3 months, respectively. 6 children showed nystagmus and 20 children had strabismus. The most common method (56.3%) for correcting visual acuity was the combination of IOL implantation and glasses that the mean best corrected visual acuity of 0.29 ±0.28 LogMAR was obtained. The complications of congenital cataract were 35 (51%) amblyopia, 17 (23/9%) glaucoma and 11(16.4%) posterior capsular opacity. Being female, nystagmus and strabismus were found to be risk factors of post-operative visual outcomes.

Early detection of congenital cataract by screening of lens opacity at birth using the red reflex assessment would reduce the age of surgery. All practitioners should attend to the probability of amblyopia, glaucoma and posterior capsular opacity in each post-operative visit of these patients.