PurposeThe potential risks and benefits of cataract surgery, in context of congenital
aniridia (CA), are not widely understood, yet. Our purpose was to investigate the
effect of lens properties on visual acuity (VA), aniridia-associated keratopathy (AAK)
stage and presence of glaucoma at the Homburg Aniridia Center. MethodsCA subjects,
examined at the Department of Ophthalmology of Saarland University between June 2003
and January 2022, were included. VA, slit-lamp examination, AAK grade, and glaucoma
evaluation data were extracted from the medical records, from the first visit to the
center. Eyes were categorized as clear lens, cataract, pseudophakic, aphakic, or subluxated
lens. Patients were grouped by age (0-10, 10-20, 20-40, 40+ years). ResultsIn 553
eyes of 286 CA subjects (age 19.9 +/- 19.9 (0-83) years, 46.1% males), analysis revealed
significant differences in VA and mean IOP (ANOVA p < 0.0001; p = 0.001, respectively)
with lens status. Lens status was strongly associated with AAK Grade and glaucoma
presence (p < 0.0001 for both). In age subgroups, AAK Stage was strongly associated
with lens status in the 0-10 years (p < 0.001), 10-20 years (p < 0.001), and 40+ years
(p = 0.02) groups and lens status was strongly associated with glaucoma presence in
the 0-10 years (p = 0.003) and 20-40 years (p = 0.002) groups. AAK Stage was the most
advanced in pseudophakic and aphakic eyes and presence of glaucoma was more pronounced
in pseudophakic, aphakic and subluxated lens eyes. ConclusionsIn a large population
of CA, previous cataract surgery was associated with higher AAK Grade and presence
of secondary glaucoma both in postoperatively pseudophakic and aphakic eyes. Our data
indicate that caution is warranted with cataract surgery in congenital aniridia.
