{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:28:22Z","timestamp":1787758102153,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe the clinical features of congenital cataract (CC) in a Tunisian cohort and to assess the surgical outcomes of primary intraocular lens implantation in two groups based on the age at surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study was a prospective analysis of children under 5 years with CC that were operated between January 2015 and 2020. The surgery consisted of phacoaspiration with posterior capsulorhexis and primary implantation. Group 1 comprised children operated at &lt;2 years of age and Group 2 comprised children operated between 2 and 5 years. Peri and postoperative surgical events as well as refractive and visual outcomes were compared between both the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty-five (84 eyes) infants were enrolled. Group 1 included 30 (48 eyes) children and Group 2 included 25 (36 eyes) patients. The mean follow-up was 27.60 \u00b1 19.89 months. The mean delay between the diagnosis and the cataract surgery was 11.97 \u00b1 13.84 months. Of 14 (16.7%) eyes with postoperative visual axis opacification (VAO), 9 (10.7%) eyes required pars plana membranectomy. The VAO was not statistically associated with the age at surgery (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.112), but significantly correlated with sulcus implantation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.037). The final mean visual acuity was 0.51 logMAR and comparable between both the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.871). Poor visual outcome was significantly associated with low age at presentation (&lt;6 months;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.039), delay between the diagnosis and time of surgery (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001), preoperative nystagmus (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), and poor parental compliance to amblyopia treatment (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Primary implantation seems to be safe and efficient. VAO appears to become an avoidable occurrence owing to better surgical techniques. Amblyopia remains the biggest barrier to final visual outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joco.joco_273_21","type":"journal-article","created":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T14:51:26Z","timestamp":1658847086000},"page":"187-193","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Features and Outcomes of Congenital Cataract Surgery with Primary Intraocular Lens Implantation in a Tunisian Cohort"],"prefix":"10.4103","volume":"34","author":[{"given":"Ines","family":"Malek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihene","family":"Sayadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takwa","family":"Sammouda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racem","family":"Choura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manel","family":"Mekni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Zghal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moncef","family":"Khairallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Nacef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-8-20240910","doi-asserted-by":"crossref","first-page":"28564","DOI":"10.1038\/srep28564","article-title":"Prevalence and epidemiological characteristics of congenital cataract: A systematic review and meta-analysis","volume":"6","author":"Wu","year":"2016","journal-title":"Sci Rep"},{"key":"R2-8-20240910","first-page":"227","article-title":"Childhood blindness in the context of VISION 2020 - The right to sight","volume":"79","author":"Gilbert","year":"2001","journal-title":"Bull World Health Organ"},{"key":"R3-8-20240910","first-page":"227","article-title":"Cataract in children \u2013 Not only an ophthalmological problem","volume":"11","author":"Gra\u0142ek","year":"2007","journal-title":"Med Wieku Rozwoj"},{"key":"R5-8-20240910","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.jfo.2016.07.008","article-title":"[Incidence and causes of visual impairement in the district of Mahdia, in east Tunisia: Retrospective study of 1487 cases]","volume":"39","author":"Ammari","year":"2016","journal-title":"J Fr Ophtalmol"},{"key":"R6-8-20240910","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/ICU.0000000000000324","article-title":"Update on congenital cataract surgery management","volume":"28","author":"Lim","year":"2017","journal-title":"Curr Opin Ophthalmol"},{"key":"R7-8-20240910","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.jaapos.2004.12.022","article-title":"Cataract extraction and primary hydrophobic acrylic intraocular lens implantation in infants","volume":"9","author":"Tuncer","year":"2005","journal-title":"J AAPOS"},{"key":"R8-8-20240910","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/j.jcrs.0000000000000015","article-title":"Comparison of visual acuity and complications between primary IOL implantation and aphakia in patients with congenital cataract younger than 2 years: A meta-analysis","volume":"46","author":"Chen","year":"2020","journal-title":"J Cataract Refract Surg"},{"key":"R9-8-20240910","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1016\/j.ophtha.2019.05.009","article-title":"Intraocular lens implantation during early childhood: A report by the american academy of ophthalmology","volume":"126","author":"Lambert","year":"2019","journal-title":"Ophthalmology"},{"key":"R10-8-20240910","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.ajo.2018.09.042","article-title":"Five-year postoperative outcomes of bilateral aphakia and pseudophakia in children up to 2 years of age: A randomized clinical trial","volume":"199","author":"Vasavada","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"R12-8-20240910","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.ajo.2014.07.031","article-title":"Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the Infant Aphakia Treatment Study","volume":"158","author":"Plager","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"R13-8-20240910","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/S2352-4642(18)30317-1","article-title":"5-year outcomes after primary intraocular lens implantation in children aged 2 years or younger with congenital or infantile cataract: Findings from the IoLunder2 prospective inception cohort study","volume":"2","author":"Solebo","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"key":"R14-8-20240910","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1001\/jamaophthalmol.2014.531","article-title":"Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: A randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years","volume":"132","author":"Lambert","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"R15-8-20240910","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.jfo.2011.01.003","article-title":"Management of infantile cataracts: Surgical technics and choices in lens implantation","volume":"34","author":"Thouvenin","year":"2011","journal-title":"J Fr Ophtalmol"},{"key":"R16-8-20240910","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1080\/17469899.2018.1555037","article-title":"Cataract in children in sub-Saharan Africa: An overview","volume":"13","author":"Bronsard","year":"2018","journal-title":"Expert Rev Ophthalmol"},{"key":"R17-8-20240910","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1038\/eye.1998.45","article-title":"Childhood blindness and low vision in Uganda","volume":"12","author":"Waddell","year":"1998","journal-title":"Eye (Lond"},{"key":"R18-8-20240910","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1136\/bjo.85.3.267","article-title":"Results of cataract surgery in young children in east Africa","volume":"85","author":"Yorston","year":"2001","journal-title":"Br J Ophthalmol"},{"key":"R19-8-20240910","doi-asserted-by":"crossref","first-page":"92","DOI":"10.4103\/0974-9233.148356","article-title":"Pediatric cataract surgery in National Eye Centre Kaduna, Nigeria: Outcome and challenges","volume":"22","author":"Umar","year":"2015","journal-title":"Middle East Afr J Ophthalmol"},{"key":"R20-8-20240910","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1136\/bjo.2005.074146","article-title":"Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania","volume":"89","author":"Mwende","year":"2005","journal-title":"Br J Ophthalmol"},{"key":"R21-8-20240910","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1038\/eye.2016.158","article-title":"Surgery for sight: Outcomes of congenital and developmental cataracts operated in Durban, South Africa","volume":"30","author":"Gogate","year":"2016","journal-title":"Eye (Lond"},{"key":"R22-8-20240910","doi-asserted-by":"crossref","first-page":"327","DOI":"10.4103\/0301-4738.116465","article-title":"Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II","volume":"62","author":"Gogate","year":"2014","journal-title":"Indian J Ophthalmol"},{"key":"R23-8-20240910","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.ophtha.2010.04.014","article-title":"Visual impairment and delay in presentation for surgery in chinese pediatric patients with cataract","volume":"118","author":"You","year":"2011","journal-title":"Ophthalmology"},{"key":"R24-8-20240910","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1016\/j.jcrs.2007.05.016","article-title":"Choice of intraocular lens for pediatric cataract surgery: Survey of AAPOS members","volume":"33","author":"Wilson","year":"2007","journal-title":"J Cataract Refract Surg"},{"key":"R25-8-20240910","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.2147\/OPTH.S176057","article-title":"Long-term outcomes of intended undercorrection intraocular lens implantation in pediatric cataract","volume":"12","author":"Lekskul","year":"2018","journal-title":"Clin Ophthalmol"},{"key":"R26-8-20240910","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/S0886-3350(03)00052-X","article-title":"Simultaneous bilateral cataract surgery","volume":"29","author":"Arshinoff","year":"2003","journal-title":"J Cataract Refract Surg"},{"key":"R27-8-20240910","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.jcrs.2016.04.028","article-title":"Outcome of primary intraocular lens implantation in infants: Complications and rates of additional surgery","volume":"42","author":"Sukhija","year":"2016","journal-title":"J Cataract Refract Surg"},{"key":"R28-8-20240910","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.2147\/OPTH.S205148","article-title":"Intraocular lens implantation in the ciliary sulcus: Challenges and risks","volume":"13","author":"Mehta","year":"2019","journal-title":"Clin Ophthalmol"},{"key":"R29-8-20240910","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.jcrs.2013.09.011","article-title":"Outcomes of congenital cataract surgery: Intraoperative intracameral triamcinolone injection versus postoperative oral prednisolone","volume":"40","author":"Ventura","year":"2014","journal-title":"J Cataract Refract Surg"},{"key":"R30-8-20240910","doi-asserted-by":"crossref","first-page":"185","DOI":"10.4103\/0301-4738.31937","article-title":"Primary intraocular lens implantation in the first two years of life: Safety profile and visual results","volume":"55","author":"Ram","year":"2007","journal-title":"Indian J Ophthalmol"},{"key":"R31-8-20240910","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ajo.2011.11.031","article-title":"Accuracy of intraocular lens power calculation formulae in children less than two years","volume":"154","author":"Kekunnaya","year":"2012","journal-title":"Am J Ophthalmol"},{"key":"R32-8-20240910","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/17434440.2016.1271706","article-title":"Current Status of IOL implantation in pediatric eyes: An update","volume":"14","author":"Vasavada","year":"2017","journal-title":"Expert Rev Med Devices"},{"key":"R33-8-20240910","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.jfo.2016.12.010","article-title":"Visual outcomes and complications of cataract surgery with primary implantation in infants","volume":"40","author":"Vera","year":"2017","journal-title":"J Fr Ophtalmol"}],"container-title":["Journal of Current Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_273_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:06:08Z","timestamp":1787756768000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_273_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/joco.joco_273_21","relation":{},"ISSN":["2452-2325"],"issn-type":[{"value":"2452-2325","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}