Características clínicas e epidemiológicas dos pacientes submetidos a cirurgia de catarata pediátrica em serviço de referência em oftalmologia de hospital universitário

Abstract

Objective: To describe the clinical and epidemiological characteristics of patients who underwent pediatric cataract surgery at a university hospital serving as a referral center in Ophthalmology.

Methods: This was a cross-sectional, retrospective, and observational study conducted in the Pediatric Ophthalmology Department of Professor Edgar Santos University Hospital (HUPES/UFBA) between July 2017 and June 2023. Medical records of patients diagnosed with pediatric cataract and treated surgically were reviewed. Data collected included demographics, clinical signs, etiology, cataract morphology, comorbidities, surgical techniques employed, and postoperative complications.

Results: A total of 145 patients (226 eyes) were evaluated, with a slight predominance of males (56.6%). Most cases (55.9%) presented bilateral cataracts, and 51% were diagnosed within the first year of life. The most common initial clinical signs were leukocoria (73.1%), decreased visual acuity (41.4%), and strabismus (22.1%). The most frequent cataract morphology was zonular (46.5%), followed by total cataract (21.7%). Etiology remained unknown in 66.2% of cases; genetic or metabolic syndromes accounted for 16.6%, and hereditary causes for 13.8%. The predominant surgical technique was lensectomy without intraocular lens implantation (76.9%). Postoperative complications occurred in 21 eyes (9.3%), with secondary glaucoma due to aphakia being the most frequent (47.6%).

Conclusion: Pediatric cataract remains an important cause of treatable childhood blindness. Although most cases were diagnosed early, late diagnosis continues to be relevant. The high proportion of idiopathic etiology underscores the diagnostic challenge, and the occurrence of complications—particularly glaucoma in aphakic patients—highlights the need for long-term follow-up. These findings emphasize the importance of neonatal screening, timely access to surgical management, and the development of public health policies aimed at preventing childhood blindness.